Lap-Band revision surgery is a bariatric procedure designed to replace your existing Lap-Band with a more effective weight loss procedure, such as Roux-en-Y gastric bypass surgery or gastric sleeve surgery.
If you have a Lap-Band or other type of gastric banding, you may be wondering about revision and why it might be necessary. You might also want to know about the surgeries used to replace the Lap-Band to get your weight loss back on track. The following information should help to make you a more informed bariatric surgery patient.
What is the Lap-Band?
The Lap-Band is actually a brand name. The surgery that employs the Lap-Band is technically called adjustable gastric banding. This is an inflatable silicone band that is placed around the upper portion of the stomach. By constricting the stomach, the space available for food is diminished. The result is the patient eats less, feels less hungry, and loses a significant amount of excess weight.
The bariatric surgeon can adjust the band to increase or decrease the size of the passageway between the dual parts of the stomach. This helps to limit or slow down the amount of food you can eat during meals.
The Lap-Band used to be the bariatric surgery of choice for many patients. Both surgeons and patients appreciated gastric banding because the procedure is minimally invasive and entirely reversible.
As time went on, surgeons and patients realized that results were not as positive as once hoped. We now know there are many disadvantages to adjustable gastric banding. In fact, studies have shown that more than half of the gastric bands that are placed are eventually removed for a variety of reasons. The follow-up surgery to remove the gastric band is known as Lap-Band revision surgery.
When is Lap-Band Revision Surgery Necessary?
There are several reasons why a former bariatric patient may require a Lap-Band revision. Lap-Bands have fallen out of favor in recent years because the devices are susceptible to problems. The device could slip further down the stomach, which can then lead to acute or chronic conditions that require emergency surgery.
The Lap-Band can erode with time, which can cause a hole to form in the stomach. When that occurs, saliva can leak through the hole and flow along with the Lap-Band tubing. This can lead to infection, not to mention it can cause the Lap-Band to fail.
Some patients may develop food intolerance because of the Lap-Band procedure. They may have trouble swallowing, develop nausea, as well as heartburn or acid reflux.
In other cases, the Lap-Band merely fails to help the patient achieve the expected amount of weight loss. And there may be minimal or no improvements in weight-related health conditions, despite the patient making all the necessary changes possible to their diet and fitness routines.
Due to these complications, Lap-Band revision typically involves the complete removal of the gastric banding device entirely. The removal surgery is then used to transition the patient to a new and more effective weight loss surgery.
It should be noted that just because you may require Lap-Band revision surgery doesn’t mean you made a poor choice in having the initial surgery. As more are discovered every day, Lap-Band surgery may not be as effective as we hoped it would be.
What Are Signs That You May Require Gastric Band Revision?
If you have experienced inadequate weight loss with an adjustable gastric band or you have regained the weight you did succeed in losing, you may be a viable candidate for gastric band revision surgery.
What is inadequate weight loss? You should be able to lose at least 25% to 30% of your excess weight with a gastric band device. If weight loss is still difficult even with a gastric band in place, a revision may be necessary.
Another sign you require a bariatric revision surgery is band intolerance. You know you have band intolerance if you have difficulty swallowing or pain after eating. You may also experience excessive nausea and vomiting several times per day.
How is Lap-Band Removal Performed?
The removal process for adjustable gastric banding is similar to the method used to implant the device during the initial surgery. The bariatric surgeon will use laparoscopic surgery, which is minimally invasive with a low risk of complications.
The procedure uses general anesthesia, which means you will be asleep for the duration of the gastric band removal surgery. Once you are properly sedated, the bariatric surgeon makes small incisions around your abdomen. In most cases, the surgeon uses the incision marks from the previous surgery, which minimizes the appearance of scars.
The incisions function as entry points for the laparoscopic tools, including a camera. The surgeon performs the surgery while viewing your internal organs on a monitor positioned nearby in the operating room.
The surgeon first cuts the scar tissue that has formed around the gastric band device. The adjustable tubing and band itself are cut into sections before each is pulled through the incision points.
During the initial surgery to implant the band, the surgeon usually sutures the upper portion of the stomach to prevent the band from slipping. These sutures are removed during the removal process before the adhesions are lysed to prevent infection. This restores the original anatomy of the stomach.
After the gastric band has been removed, the dense scar tissue around the upper portion of the stomach or esophagus is removed to prevent obstruction and subsequent digestive issues. The subcutaneous port that was used by the gastric band is also removed.
At this point, the surgeon has the option of stopping the surgery and closing the incisions or transitioning to a different and more effective bariatric surgery.
How Do Surgeons Convert Lap-band to a Gastric Bypass or Gastric Sleeve?
There are many benefits to converting the gastric band to a different bariatric procedure. These include:
Significant Weight Loss
If you had trouble losing weight with gastric banding or you ended up regaining any excess weight you may have lost, the gastric bypass or gastric sleeve can bring about a refreshing change. Patients tend to experience much greater weight loss with gastric bypass and gastric sleeve when compared to Lap-Band surgery. You can potentially lose up to 70% or more with gastric bypass surgery and 50% to 60% or more with gastric sleeve surgery.
Improved Quality of Life
If you experienced nausea, vomiting, heartburn, and other issues with the Lap-Band, you are unlikely to experience those problems with a more effective bariatric procedure. Gastric sleeve surgery in particular has an extremely low risk of complications. You will also feel less hungry after the gastric bypass and gastric sleeve, which helps you lose weight over the long term.
Low Risk of Complications
While the gastric bypass can cause nutrient deficiencies, leading you to supplement with vitamins, the gastric sleeve is low risk compared to the Lap-Band. This is especially true when you consider over half of all Lap-Band surgery patients need to have their gastric bands removed at some point.
Read our article: Little Known Benefits of Bariatric Surgery
How is the Lap-Band Converted into Gastric Bypass Surgery?
This procedure is known as the Lap-Band to bypass revision surgery. After the gastric band is removed, the majority of the stomach tissue is removed. The leftover stomach is converted into a small banana-sized pouch. If you recall, the Lap-Band was designed to constrict the stomach to limit how much you could eat. This portion of the Lap-Band to bypass procedure aims to do the same.
The surgery is irreversible, and you can live perfectly fine with the fundus removed. That’s the part of the stomach that is cut away. The fundus, incidentally, is also responsible for sending out hunger hormone signals to the brain. With that part of the stomach removed, you end up feeling less hungry and less deprived overall as you lead a healthier lifestyle following the procedure.
Read our article: How Gastric Bypass Surgery Makes Weight Loss Easier
After the stomach is converted into a pouch, the stomach is rerouted to a portion of the intestine. The purpose of this part of the surgery is to limit the number of calories and nutrients that end up being absorbed by the body.
How is Lap-Band to Gastric Sleeve Revision Performed?
Read our article: Can You Convert the Lap-Band to a Gastric Sleeve?
Gastric sleeve surgery is similar to gastric bypass in some ways but different in others. The main similarity is that, with a gastric sleeve, a majority of your stomach is removed. After 80% of your stomach is removed, the remaining tissue is fashioned into a pouch the size and shape of a banana. As with gastric bypass, you end up eating less and feeling less hungry overall.
Read our article: Gastric Sleeve Surgery: How Do You Know It’s Time?
Read our article: Does Gastric Sleeve Surgery Affect the Hormones?
Unlike gastric bypass surgery, none of your organs are diverted. In fact, only your stomach is affected during this surgery, which is why there is such a low risk of complications.
As with the Lap-Band, you must do your part to maximize the amount of excess weight you can lose with a gastric sleeve or gastric bypass surgery. That includes eating a sensible diet and getting regular exercise. Your bariatric surgeon can help with these aspects as part of your bariatric surgery treatment plan. You may be put in contact with a dietician or nutritionist, fitness expert, and psychology expert to ensure you have all the tools you need at your disposal to lose the most amount of excess weight.
Read our article: Lifestyle Tips to Help you De-Stress Without Alcohol or Food
Are There Risks Associated with a Lap-Band Revision or Conversion?
The risks of a gastric band revision or conversion surgery can be higher than the initial bariatric surgery. This is due to the fact that scar tissue is present, and your anatomy has been altered. This is why it is important to work with a surgeon that has experience in Lap-Band revision surgery. The first step is to schedule a consultation with that doctor.
Read our article: What to Expect from Your Weight Loss Surgery Consultation?
Read our article: Questions to Ask When Considering Gastric Sleeve Surgery
During the consultation, you and your doctor will go over the unique risks of the surgery in greater detail. The surgeon will likely mention that there could be complexities to the surgery because of scar tissue buildup and adhesions performed during the initial procedure. Your surgeon has a vested interest in preserving your health and minimizing risks. As long as you are otherwise healthy, you could be a viable candidate for a Lap-Band revision or conversion surgery.
What Next Steps Should You Take?
If you have had trouble losing weight with the Lap-Band or you have had issues like heartburn and nausea with gastric banding, a revision or conversion surgery could help. It is important to remember that you have not failed as a bariatric surgery patient. You are also not alone. There are many people in your shoes and help may be a phone call away.
Schedule a consultation with world-renowned bariatric surgeon Dr. Babak Moeinolmolki by contacting Healthy Life Bariatrics in Los Angeles, California. Dr. Moein and his professional staff offer compassionate help for weight loss using a variety of procedures, including gastric bypass and gastric sleeve surgery. Call to choose a time for your consultation that works best for you – .