Coming out to the closet!

Well, I've known for a while, but was hoping it wasn't so....I have to have my lap band removed!  I have a major slip with my band and it has to come out.  I'm not having any problems at all!!!  The only way we found out that I had a slip was via a barium swallow.  The dr said it is too dangerous to leave it the way it is due to the fact my stomach could twist and that would be a critical situation.  My insurance will not approve me for any other type of bariatric surgery.  I should have gone with RNY in the first place, but of course, I had the same concerns as most people and went with LapBand.  They are finding out the a lot of lapbanders are have problems with the band 2-3 years out from surgery.  I'm waiting to hear from my dr when the surgery will be.  I'll try and keep you all updated.  I"m at the gym and working out to help me stay my present weight or maybe even get rid of these last 25 lbs.  Please pray for me!!  Thank you!
Andrea

I'm so sorry to hear about your troubles!  What made you decide to get the swallow test if you didn't have any symptoms?   You're very lucky you did! 

You're in my prayers for a painless band removal and success once the band is removed.  You have the skills you need to succeed and we're here for you with or without your band.  If you haven't already, this may be a good time to seek some therapy to brush up on the Congnitive Behavior therapies that will help you NOT turn to food like we used to before the band.

Keep us posted.

Lisa O.

Thank you so much!! 

Sorry to hear about your slip, but I can't believe you have a major slip with NO symptoms at all??, that is the first I've heard of that in my 5 years with the band. Typically most people with slips ( HAVE MAJOR SYMPTOMS) and have to be dragged to the OR to get their bands removed, so you mean to tell me you are willing to get your band taken out and you are asymptomatic? Typically there IS symptoms with a band slip especially a major one.

I would get a second opinion on that from another band surgeon with an Upper GI or endoscope to make sure you REALLY have a slip, coz trust me with a MAJOR slip you will know it, and will have frequent vomiting, pain in the chest or reflux, and your quality of life will impacted.

I've had two different surgeons from two different offices tell me I had a slip and I saw it for myself while doing the barium swallow.  My pouch above the band is the size of a SOFT BALL instead of a golf ball.  My first surgeon does all his fills flouro, thats were we first saw a slip, and then when I went to the second surgeon and he read in my records that there is a slip, so he ordered a second barium swallow so he could see the degree of it for himself. I have some heartburn at night and that is it, nothing 2 tums can't take care of.  I also have 3 small children.  I can not risk the chance of a twist and being rushed into surgery and risking having part of my stomach removed because of blood lose to that area.  Everyone is different, I'm just BLESSED that I don't have the usual symptoms.  Believe me, every time I go to the dr's they ask me over and over again,...."are you sure you're not throwing up and just not telling us,   are you sure you're not in any pain and don't want to tell us because you don't want your band removed??"  that is not the case with me.  THANK GOD!!
Thank you for your concern and advice!
Andrea

Ok, I see you have a very enlarged pouch, which can lead to a full prolapsed band slip if not treated in time.  That is a big difference than a full band slip that is why you probably don't have the typical symptoms of a true prolapse, many people do not know or understand the differences between a band slip and pouch dilation, pouch dilation's is a milder form of band slip which eventually WILL progress to a band slip if not treated, typically pouch dilation's CAN be treated if caught in time.  Pouch dilations are a result from being too tight; which will cause the pouch to enlarge and swell and if it gets too large the pouch will hang over the band to the point of prolapse, when the band prolapses it turns into an emergency slip in most cases.

I had a mild pouch dilation about 3 years ago, but my surgeon caught it in time and totally unfilled my band for 6 weeks, this is the usual treatment, but I DID have symptoms with my pouch dilation of reflux and pain, ANY type of reflux, frequent vomiting or pain I run to my surgeon, some people sadly think vomiting daily is normal with the band. I am sure in your case, you probably did not have many symptoms but you did mentioned reflux....FREQUENT REFLUX is the NUMBER one early symptom of a problem with the band and sadly so many ignore this...I wish you luck with your band removal...

No, my band has slipped to the middle of my stomach, so the portion that is above the band is the size of a softball.  I have half of my stomach above the band and the other half is below the band.  I've been unfilled since they found the slip(July 2008), but nothing has changed for the better.  I have never had a problem with vomiting, just a little heartburn which I talked to my dr about and he wasn't too concerned about it, due to the fact that it was so mild.

That is typical of a pouch dilation, pouch dilation's are VERY COMMON especially in long term bandsters, more than is reported on these boards, because many do not even know their pouch is dilated unless they have an Upper GI or is having bad reflux...when the reflux first starts this is when the pouch starts to dilate (grow) if the band is not totally unfilled in time, meaning right away within a month or two, the pouch will continue to grow to the point of prolapse apparently your band has gotten to the point of prolapse and the surgeon did not catch it in time to reduce the growth of your pouch, and a total unfill did not help because your pouch is too large, hopefully you can revise to RNY, good luck. 

LOL  I knew at least on Lapbanded would try and diagnose me over the computer!!LOL  Maybe my surgeons should get on OH to find out what is really going on with me!!!  Their medical degrees and years of experience don't even compare to the knowledge people have here on OH!!LOL  This is too funny! 

I am not trying to diagnose you, trust me but I know about the lap band inside and out....here are some studies from REAL doctors this may help you and others....it fully explains how pouch dilation's can progress to a full band slip if not treated in time.....

A clinical study was done in Germany to review complications following lap band surgery. Thirty-five hospitals were involved in the study, with 4138 patients that underwent gastric banding over a five-year period.  Lap Band long-term complications were described in 8.6%  of all patients.  The most common complications included: pouch dilation or enlargement (5.0%), lap band slippage (2.6%), and Lapband migration or erosion (1.0%).   (Stroh,C  Manger, T “Complications after adjustable gastric banding", Chirurg, 2006, Vol 77,pag 244-250)

 Normal Lap Band X-Ray Under Fluoroscopy

  Enlarged Lap Band Pouch    

What is Lap Band Slippage?

One of the long-term complications of lap band surgery is called “Lapband slippage" and can be defined as “when the Lapband and the stomach pouch are both prolapsed."  This means that the lap band has shifted position and the enlarged stomach pouch has also shifted or twisted so that food does not go through the lapband into the rest of the stomach. This may result in pain, discomfort, decreased appetite and inability to eat or drink, and vomiting. Lapband Slippage does not happen immediately but may take several months to develop. 

Large Lap Band Pouch

Lap Band Slippage generally develops in a progressive manner. As food intake is increased, the stomach begins to stretch and grow and the patient may stop losing weight or start to regain weight.  At this point, patients may only exhibit an enlarged stomach Lap band pouch.  This can be medically treated by deflating the lap band to release pressure and slow the growth of the pouch (successful in 70% of cases, or surgical treatment can be considered). However, if the enlarged lapband pouch continues to grow, the lapband progressively rotates until both the lap band and the enlarged pouch become prolapsed, resulting in Lap band slippage.  This is followed by functional stenosis (narrowing) of the stomach.  

 Lap Band Slippage

Lapband Slippage Symptoms typically include progressively worsening reflux, vomiting and epigastric complaints, which may increase to sudden near-total dysphagia (inability to swallow or eat anything, including saliva).

Risk factors or causes of lap band slippage include surgical technique, model of the  lapband used, early consumption of solid foods, early inflation or filling of the band, consumption of carbonated or sparkling beverages, and frequent vomiting.

Treatment for lap band slippage requires surgical intervention. The lapband must be repositioned or removed, based on the operative findings and condition of the stomach pouch. If appropriate, the surgeon and patient may elect to choose another type of bariatric procedure such as a Gastric Sleeve. 

How Do I Prevent Lap Band Slippage?

In order to decrease the risk of developing lap band slippage, it is important to follow the recommended diet following surgery and to avoid introducing solid foods too early.  In addition, the fills should not be started before 6 weeks post-operatively and these Lap band fills should be very gradual.  We also recommend that fills should be done under fluoroscopy, even if you are asymptomatic (no symptoms of lap band slippage), to be able to monitor the position of the lapband, and the size of the stomach pouch and condition of the esophagus. This will allow for early diagnosis of an enlarged stomach pouch or possible lap band slippage.