Failed lap band - Lost & desparate

Hello everyone,

I am desparate.  I have been surfing the web for days.  I just found this site and thought maybe I could better answers from people not trying to sell me their services and  people who could relate.

 I had a lap band put in May 2004. I need a revision.  I have had complications (vomiting, acid reflux, not being able to get anything down - even unfilled) and have been seeking answers but am getting completely conflicting opinions.  My band has not slipped or eroded but they feel I probably have a lot of scar tissue and that a revision could be dangerous.  I have been told the gastric sleeve is the safest and then told by another its the most dangerous after lap band.  I have been told gastric bypass (RNY) is the safest and then been told it is the most dangerous after lap band(due to my upper stomach tissue possibly being compromised).  I am a self-pay and I am just so sick about all of this.

When I got the lap band I really did a lot of research.    Now I feel like a DUMMY.

My original surgeon does not do anything but lapband and is in Mexico.

Any suggestions of a surgeon who is straight up and specializes in revisions? 

 

I would ask your doctor for some recommendations as far as doctors who do WLS revisions in your area.  Have you tried the find a surgeon on the site?

I had the lap band in October 2005.  Same things as you went through, I did.  I had a revision to the sleeve in October 2008.  The doctor was going to do the RNY but there was too much scar tissue so there was too great a chance of leakage with the RNY so he did the sleeve.  I have had no problems, and things are going great.

Hello Vicki,

It was so nice to hear from someone else who had to have a revision - not that I'm glad you had to.  My local doctor did not agree with the WLS because she is a tiny little thing who has never gained a pound in her life. I know I need to find another one but I travel for business weekly and it is hard to find the time and otherwise she is a great doctor and I like her. 

I have actually personally talked with several doctors.  I am getting a different story from each.  One said the sleeve was dangerous because of possible leaks and that RNY was safer and another said just the opposite.  Another said he thinks I have a hiatel hernia that was missed on my tests because I was so swollen and they couldn't hardly see anything.  Another has said they think I might have an ulcer.   Huhhh!!! None of them have agreed upon anything.  I also contacted  Dr. Rutledge's people  who does mini gastric bypass (reversible) and he has done a bunch of lap band revisions.  He hates the band - says 70% end of failing in the long run.  However, I found out the procedure he is doing is a form of one they quit doing because the level of bile in ones system was 13 times a regular person would have and that can cause cancer and all kinds of nasty stuff.

I am just about ready to cry from frustration because I cannot go on living in this constant guessing game from one bite to the next whether I will be sliming, vomiting or giving my meal away I just bought in a restaurant.

Where did you get your revision and if you don't mind me asking what did it cost ?  I am willing to go anywhere as long as the doctor is experienced in revisions and is within reason (I will be paying for it myself).   I have been told by a couple of doctors when we have scar tissue we are definately at higher risk for leaks which is very dangerous. So I am going to be sure I have a good doctor.  My original lap band doctor does only  lap band and was in Mexico.  I know a lot of people don't agree with Mexican doctors but when you are paying for it yourself it does make a difference.  When I had the band done, I checked my local bariatric surgeon and he wanted $30,000. He was nuts.  I was banded by Dr. Kuri and he still has a very good reputation.  He is willing to take my band out for cost, but then I have to wait 6 months for a revision due to heal time. 

If you don't want to post openly, please feel free to e-mail me at [email protected].

PS.  Where are you from?  Me - Indiana.  Thanks again.

Hi there,

I'm feeling for you!  Have you tried searching using terms that will likely to yield some research studies in order to get information?  For instance, I just googled "lap band revision study options" and got the info below.  It's always good to include "study" in your search if you want to get information from a study as opposed to individual surgeons who may a personal bias towards one type b/c that's the type they do or financial stake in the matter.  Try googling a bunch of different key words in different combinations.  In case you don't know - the results of your search will always be listed in accordance with the words you entered in a search.  For example, in the example of what I searched for above in google, "lap band" was given more of a priority for needing to be in the result list than "revision" was.  If I had put revision before lap band, revision would be given more of a priority.  You'll have a problem with only being able to view abstracts a lot of the time, but generally, that will serve your purpose.  I think that the most important criterion in selecting a surgeon based on everything I've read is to find one who has a good amount of experience with revisions from lap band.  Most surgeons are trained in various bariatric surgeries, but revisions are more challenging, so getting one who's already gone through the trial & error/ learning process is your best option.  Good luck!!!!!!!!

Laproscopic revision from LAP-BAND to gastric bypass
Abstract:

While the majority of patients achieve good outcomes with the LAP-BAND^®, there is a subset of patients who experience complications or fail to lose sufficient weight after the banding procedure. This study examines the feasibility and outcome of performing laparoscopic Roux-en-Y gastric bypass (RYGBP) as a single-step revision surgery after a failed LAP-BAND procedure.

 

In the past five years we have performed more than 1400 LAP-BAND procedures. We laparoscopically converted 33 (30 females) of these patients (mean age = 43.8 years) from LAP-BAND to RYGBP because of inadequate weight loss and/or complications. Key steps in the revision procedures were (1) identification and release of the band capsule; (2) careful dissection of the gastrogastric sutures; (3) creation of a small gastric pouch; and (4) Roux-en-Y anterior colic anterior gastric pouch-jejunum anastomosis. Revisions took place at a mean 28.2 months (range = 11-46; SD = 11.3) after the original gastric banding. Change in body mass index (BMI) between pre- and postrevision was evaluated with paired t tests.

 

Among the 33 patients who would undergo revision surgery, the mean BMI before the LAP-BAND procedure was 45.7 kg/m² (range = 39.9-53.0; SD = 3.4) and the mean weight was 126 kg (range = 99-155; SD = 17). The lowest BMI achieved by this group with the LAP-BAND before revision was 39.7 kg/m² (range = 30-49.2; SD = 4.9); however, the mean BMI at the time of revision was 42.8 kg/m² (range = 33.1-50; SD = 4.8). The mean revision operative time was 105 min (range = 85-175), and the mean hospital stay was 2.8 days (range = 1-10). Complications included one patient who underwent open reoperation and splenectomy for a bleeding spleen and one patient *****quired repair of an internal hernia. After conversion to RYGBP, mean BMI decreased to 33.9 kg/m² at 6 months (p < 0.001) and 30.7 kg/m² (range = 22-39.6; SD = 5.3) at 12 months or more of followup (average = 15.7 months; p < 0.0001).

 

Laparoscopic conversion from LAP-BAND to RYGBP is safe and can be an alternative for patients who failed the LAP-BAND procedure. However, revision surgery is technically challenging and should be performed only by surgeons who have completed the learning curve for laparoscopic RYGBP.

Hi,  I am in the same boat.  I had my band removed in emergency surgery Sept. 19.  I gained up to 220 in no time. I am now low carbing and have lost 5 lbs.  I am leaning toward the sleeve.  I had my surgery in Mexico with my removal here in states.  My insurance did cover the removal and my understanding is that it also covers banding, the sleeve and RNY.  I will not have RNY or DS at this point due to the problems my daughter had from RNY.  I have heard that Dr. Husted and Dr. Pleatman who is in Bloomington Michigan are the best with revision from band.  Dr. pleatman does lots of sleeves. I know historically Husted was big on the DS.  Since he has loads of experience in DS I would think that he would be very expert on the VSG.  If my insurance doesn't cover and I decid to have sleeve I will go to Dr. Zapata in Monterrey, Dr. Rumbaut in Monterrey or Dr. Alvarez in Piedras Negras just over the line from San Antonio.  Dr. Alvarez does 2 sleeves for every band.  Those are the only surgeries he does.  His patient coordinator was banded and lost her band then sleeved almost 3 years ago.  She loves her sleeve.    I know Dr. Zapata because he checked out my band for me and pulled out all the fluid when I first started having such bad problems.  He is a great guy.  He is represented by Ready4Achange and they are good folks.  I went through them to see Dr. Sanchez when I had my band.  I loved that band as long as it did well, but my body didn't like it.  I did not have a slip, my stomach occluded, but no slip.  My local doc doesn't do the sleeve or I would have him do it since insurance should cover.  Insurance might not cover since I am not a hundred lbs overweight.  Hopefully I won't be, but who knows.

Good luck to you,
Corliss
(Mahage)

HI, I HAD MY LAP BAND DONE IN MONTERREY IN MAY OF 2007 , WITH DR HORACIO GUAJARDO, WHO WAS WORKING WITH DR RUMBAUT, IT WENT GREAT LOST 100 LBS FOR AT LEAST 2 YEARS , BUT KNOW I'T HAVING SO MANY PROBLEMS  I JUST CAN'T GE THE RIGHT FILL, HAD TO GET UNFILLED, BECAUSE IT WAS TO TIGHT, I WENT MANY NIGHTS WITH OUT BEEN ABLE TO SLEEP, IN JULY OF THIS YEAR I GOT ANOTHER FILL  BUT I STILL DON' T FEEL A GOOD RESTRICTION, I DON'T KNOW WHAT ELSE TO DO , I HAVE GAINED 15 LBS BACK I' GETTING DEPRESSED, I EAT A LOT OF ICECREAM , AND I KNOW THAT IS NOT GOOD BUT I' CANT HELP IT, I FEEL THAT I WAS A WATE OF MONEY , I DO HAVE TO SAY THAT I CAN'T BLAME THE DOCTOR COMPLETELY HE HAS BEEN VERY GOOD, HES A GREAT DOCTOR

IS ANYONE HAVING THE SAME PROBLEM , PLEASE ADVICE DON'T KNOW WHAT TO DO

Dr. Pleatman is NOT a revision surgeon!  He's not even a full time bariatric surgeon.  He does maybe 100 bariatric surgeries a year.  To put him in the group of revision surgeons is... wrong.  He has a very high leak stat (2.4%) and has very limited experience in band to sleeve or band to bypass.  He doesn't even do DS to my knowledge.

Dr. Husted is a true revision surgeon.  He can take down RNY and revise to a DS.  THAT is a true revision surgeon.  There are only a handful of doctors that can do this.  To put Pleatman in that league is laughable. :o/

Hello,

I am so sorry to hear of your situation.

Check out Dr. John Husted.  I first learned about him through a television show.  He performs all types of bariatric surgeries, and is known as expert in the field of weight loss revision surgery. 

In fact, his website talks about revisions....
http://www.johnhustedmd.com/revisions.htm

He is in Somerset, Kentucky.

I hope this helps.

Deb
kccruisecats

I feel for you! I'm so sorry to hear that you're having trouble.  If you are considering a revision surgery, my only suggestion is to do a web search for "Bariatric Center of Excellence".  You definitely want to go somewhere that they hold themselves to a higher standard.  Centers of Excellence must demonstrate a higher than average success rate and a lower rate of complications.  I see Dr. Jefferson Vaughan in Jupiter, Florida.  He makes a great living fixing other surgeons' work.

The type of procedure that you choose should be thoroughly discussed with your doctor.  No one choice is right for everyone.  Even if you do all your homework, things can and do go wrong.  I have not had a smooth ride either.   Definitely look for someone with the highest credentials.

Good luck,
Natalie

I'm just surfing around OH and saw your post.  Not sure if you've visited the VSG forum but there are quite a few LapBand to VSG revisions and maybe their input can help you.

http://www.obesityhelp.com/forums/vsg

Ms Shell