Slipped Lap Band

 
You have a good surgeon, stay with him.

There was an ASMBS conference in Florida about a year or so ago and the heavy hitter revision surgeons (those that can take down bypass and do DS, only a handful can do that) were saying not to surgically reposition or replace a band.  The patient will have something like a 70% chance of another slip in the first year or two.

You can get a surgeon to reposition it, just know you'll be back again eventually for a revision to another sugery type assuming insurance will pay for a 3rd WLS.

 
Oh wait... I didn't realize he hadn't even unfilled you yet.  I guess I thought since you were talking surgery the unfill did not work.

It is dangerous to leave a filled band in with a slip.  You could easily obstruct.  At the very least you need an unfil quickly.

Wow this is depressing for me.  My lapband slipped and Dr was going to try and replace it since it was one of the first lapbands.  During surgery he found I had some erosion so he could not replace the band.  He told me i would have to wait 5 months for my stomach to heal .  That was in Dec.  My insurance does not cover bariatric surgery in  2011. I have working on ways to get my band back on but if now I'm depressed after reading this post about ruaccurace.

 
You need to find another doctor.

You NEVER reband someone that eroded.  Not ever.  If someone erodes once they will almost surely erode again.  Top that off with increased risk of a slip?  Make no mistake, erosion is dangerous, very dangerous.

Your doctor is very inexperienced in WLS.  He's only done about 230 bands and only 25% of his practice is devoted to bariatrics.

To add fuel to the fire the reason he's wanting to reband you is because that is the only bariatric surgery the man does.    Well, that and Stomaphyx which is a surgery for failed bypass and it is proven not to work.  Go on the revision board or the main board and just ask what people's opinion is of Stomaphyx.  Look through the revision board for Stomaphyx people for the last few years it has been available.  I have been reading the revision boards for about 4 years now and I have never seen a single successful Stomaphyx patient.  The story is always the same, they lose about 20# on the post op diet and as soon as they start on solids they regain those 20#.  I'm talking 100% of the time.  Most doctors refuse to do the procedure but those who do?  They do it because ins does not cover the surgery and it's easy self pay money.  Please, don't take my word for it.  Go see for yourself.  It's right there available for you to read for yourself.

I'm a 'bottem line' it person and I'm telling you, you need to find another surgeon.  One experienced in all the surgery types.  Banding is easy for a surgeon, a monkey could do it.  The more you start climbing the ladder of surgery types you start needing more skill.  There is cutting and staple lines involved.  Your surgeon can only do the easy stuff and he doesn't even know his stuff on that topic.

Go to a true revision surgeon and get a 2nd opinion.  You are self pay now, I've been self pay twice for a band and then a revision to a sleeve.  I feel your pain.  I just don't want you to self pay for another band and then self pay for another surgery type after that.  Worse case scenario you erode again and the damage to your stomach is so significant you can't have any surgery type in your future.  You'll be left to diet and exercise alone.  Now, that's rare but it does happen.  Usually a true revision surgeon can do a new surgery type but to be really honest, your doc is an inexperienced band mill. :o(  Of course he's going to suggest another band, it's all he knows how to do.

You have to understand, bariatrics is GOOD money!  All the surgeries, the revisions, the complications... it's a cash cow.  A few years ago general surgeons wanted a piece of that pie and they started doing bands.  It doesn't mean they have a clue what they are doing, but they wanted some of that money.  I'm just going to take a shot in the dark that this describes your surgeon.  I don't even know the man, but I don't have to.  To reband an eroded person is sheer insanity and a 2nd erosion waiting to happen.  There is minor debate about rebanding a slipped person but most surgeons know it's not a good idea.  There is no debate about rebanding an eroded person.

You don't just have scarring and adhesions from banding, you have scarring from the erosion! You need a real revision surgeon anyway.

It's up to you but I am telling you the truth.  I don't want to see you self pay twice like me.  I will help you any way I can, I'll even talk to you on the phone and go into detail about the stomach anatomy and why this is such a big deal, I'll do whatever I can for you.  Just please don't get another band.  Not after an erosion.  That could be very dangerous.

Lot to think about .  I am so grateful you took the time to respond to me and I will  use everthing you have told me.  I will also do a lot more research.  I can not do anthing right away . Financially not ready.  But I hope before 2011 is over.  I will most likley be talking with you more and I have briefly checked out your blog.  Hope is will be ok to contact you through email if I have questions?   The Dr. office did send my insurance information on the surgery.  I thought it might be worth a shot since the band was on and came off  due to complications, after reading your post I am  doing more research first .  Thanks

 
I am willing to chat, PM, email, whatever.  Makes no difference.  If you choose to stay with your current surgeon I just want you armed with information so when you go to talk to him he can't buffalo you.  You can pull out stats and studies, ASMBS info, you'll know everything off the top of your head but you'll be able to pull out the proof as well.

My email address is on my blog.  First page.

Yes it is definately something to be depressed about! I would NEVER get another band. I would not recommend the band to my worst enemy.

If  you have previously had a slip it greatly increases your chanced of having another one...........plus the fact that you have had errosion also............please give this some SERIOUS consideration! I would hate for your to end up with even more damage from a 2nd band (that might not even work!)


I would strongly suggest you visit the revision forum.

Good luck!

Thank you Maria. I guess i was wishing for a replacement because it would be the less evasive .  I doubt that  i will do anything for a while but I will for sure do more research thanks for your response.  Any suggestions as for as type of surgery i should consider?

I am going to try to revise to VSG, but I think VSG, RNY and DS are all good options. I have noticed on the revision forum though that after the band that RNY does have the highest % of revisions. A major difference between band and RNY revisions is that most of the RNY'ers that have revisions had lost all or most of their weight and then gained all or most of it back. A lot of band revisioners though never got anywhere near goal.

VSG would then be next as far as revisions (although I have only seen maybe 2 or 3 VSG revsions), Then DS (I have heard of 1 or 2 DS revisioners)

I wish u the best of luck in whatever path you choose!

i had mine taken out and i have never felt better.  sned me a private message if you want to talk more.