Great ARTICLE CAUSES of BAND Slippages and PROS and CONS to each Surgery

 

A Clinical Study

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.

The last 10 years I have been very busy participating in a lot of meetings around the world.  I have found, unfortunately, that we have spent such a long time discussing what procedures are the best for treating obesity that we have forgotten the main point, the core of any of the procedures’ success: the patient.

We all look like fans of a football team, cheering for their favorite team.  Some doctors cheer for the Gastric bypass as the best and only option to cure obesity. Then we have the doctors that prefer the lapband as the first option. In another corner, there are the doctors that promote the Gastric sleeve as the new treatment for obesity and Type 2 Diabetes.

There are several good medical reasons involved in the doctor’s preferences for one procedure over the other but also their preferences points toward which procedure the doctor feels more comfortable performing or is more skilful.  In Mexico, we have to add to this discussion, the place were the doctor was trained, for instance, if he was trained in the Mexican Health Care System they will know very little about the Lap band and would prefer to perform the Gastric Sleeve or the Gastric Bypass.  This is because the Lap band is not yet available for the government hospitals.  This means that these doctors started with Bariatric procedures such as the Gastric Bypass 3-4 years ago, and the Gastric Sleeve 1-2 years ago.

I personally recommend the Lap band as the first option. There is less risk for operatory complications involved, it is less expensive and it’s adjustable.   You don’t have to be overly obese to have the Lap Band.  You can have Lap band revision in case the lapband fails the first time or jump to any of the other procedures available including the Duodenal Switch. The Lap-band also helps in the control of co-morbidities related to obesity such as high blood pressure or Diabetes in almost 6 out of 10 patients.

The arguments against having the Lap band as the first option are valid with patients that have difficult behavioral control such as alcohol abuse. Arguments are also valid for patients that don’t like the idea of having lapband fills done periodically or when there isn’t a doctor or center to do the fills close to where they live.  The arguments against the Lapband that are not valid, are erosion rates (less than 2 %), slippage (less than 4 %), or obtaining insufficient weight loss as a strong argument for deciding on other surgical options such as the Gastric sleeve or Gastric Bypass.

There are no “complication free" bariatric procedures.  With any bariatric procedure there are advantages and disadvantages.  We also found that with all bariatric procedures, there is a chance for insufficient weight loss and a chance that patients may need revision surgery. Mean percent excess weight loss at five years ranged from 48 to 74 % after Gastric Bypass and from 50 to 60% after Vertical Banded Gastroplasty, the same results are for the Gastric Sleeve.

However, with all this in mind, we must remember that the best and most effective procedure will ultimately depend on the individual patient that is looking for a weight loss procedure.  The patient and doctor must work together to discover all the facts and make the best informed decision in order to be successful. Don´t rush your decision – get informed!

source:

http://arturorodriguezmd.com/tag/lapband-slippage

Thanks for the information. I often wondered how you would know if your band slipped. Very interesting.

"I personally recommend the Lap band as the first option. There is less risk for operatory complications involved, it is less expensive and itÂ's adjustable. You donÂ't have to be overly obese to have the Lap Band. You can have Lap band revision in case the lapband fails the first time or jump to any of the other procedures available including the Duodenal Switch. The Lap-band also helps in the control of co-morbidities related to obesity such as high blood pressure or Diabetes in almost 6 out of 10 patients."

Is this your opinion, Nana.....or the authors?

http://arturorodriguezmd.com/tag/lapband-slippage

If you follow the source to the link you can see it is the Authors and NOT my opinion... I am not the cheerleader you THINK I am for the band...but when there is BS and lies about complications; I feel I need to come in and clarify and educate

I am not bias against or pro for the band I am PRO for any surgery that offers less complications long term and effectiveness...the first 2 years with the band ARE CRITICAL FOR SUCCESS AND THE HARDEST -- but ALL that hard work pays off in the end, if you followed post op rules allow the band to heal, get your fills for optimal weight loss, and follow band rules ....now at 6 years my banded life is carefree...no more fills, I eat what I want the band just keep my meals small, I do chew papaya enzymes DAILY to keep my pouch cleared and sometimes I chew a pepcid if I eat things that give me heartburn, I walk about 1-2 miles 2 times a week, when I was in losing mode I walked DAILY to get my weight off ....and only 1 multi vit per day or calcium and that's it...small price to pay

I didn't take the time to follow the link-----my thanks

Thanks I needed a good read today.

I really wanted to thank you because it's been it's been six days after my lap-band surgery and I have to be on a full liquid diet for five more weeks and I was thinking OMG how can I do it and I posted a post about it and many people commented in which I thanked and they all think that's a very long time and that my doctor can be wrong. But after reading this article once again im releaved because that's how my doctors feels not to introduce food to early because your body has to heal on its on. SO THANKS I FEEL MUCH BETTER! 

Good for you for allowing your band to HEAL! So many don't, Healing is extremely important, the band is a foreign object that has to form scar tissue and sit securely in place and if the patient get a fill too soon it can interfere with how the band is placed and how it heals...and cause slippage easily after a tight fill years later...sometimes if fills are given too quickly the band can also heal in the wrong place, this is why you hear so many complain of pain and eating and discomfort because the band did not heal properly....it is ALL COMMON SENSE.

Are their stages to your 6 weeks liquids, full liquids, puree, mushies or it it just liquids? I move to puree tomorrow for 3 weeks.

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.

Yep!!  My band slippage was due to surgical technique and I had all of those symtoms! I pray that I never have to go through that again!