Considering Lapband. Thoughts?

I have 95% decided to get the lapband and am busy with all of the preop stuff such as insurance hoops but I was just wanting to hear some more stories, good, bad, great, and ugly.  I am a generally healthy person so I am not too worried but hey, things happen and I just wanted to know beyond the statistics what seems to happen most.  Thank you and sorry for the typos, I'm moving through this rather quickly today :D.

Ask yourself why do you want the band, have you thoroughly researched ALL surgical options? PROS and CONS?

All weight loss surgical options carries risks of complications, you have to decide if the Lap Band benefits are greater than the risks for you.

Hopefully you've read all the negativity about the band, if you have not, you may have been on another planet..LOL..just kidding... you have a whole lot of learning to do and need to research it in-depth to see if fits your lifestyle and medical background.

It was the SAFEST and best option for ME, below are a list of contradictions with the band for you to read through and hopefully can help you determine if the band is right for YOU.

If others tell you NOT to get the band because it causes complications hopefully you are not naive enough to believe the Sleeve, RNY or DS is risk and complication free, they have their own set of issues.

If you intend to work your band by never exercising, never following up with your surgeon, never eating lean proteins, never following the eating rules, please save yourself misery and don't get the band.

The band works by satiety and restricting your meals, ideally you should always be able to eat small amounts of solid foods, about 1/2 to 1 cup of solid food per meal, if you don't have anything wrong and chew your food well, you should not have many adverse symptoms of vomiting, band friendly meals are always moist, moist protein and water will be your friend, dry thick food will be your enemy.

That being said: I've had my band going on 8 years, so I am experienced vet with the band, I've had issues with my old band, but nothing to cause repeated hospitilizations, being too tight were the only issues I've ever had, last year my hernia got inflamed and started to bother me, I had a revision surgery and got a new band replaced, the older bands were more prone to issues, I have the AP band and it is working great for me now, great restriction without all the heartburn and issues like my old band.

I don't know what the future may hold for me with my new band, I will take each day one at time, follow rules, work my band, exercise and follow up with my surgeon and be honest regarding how I am feeling, that is the best advice I can give you.

I got the band because I can get it removed if anything goes wrong. Below are the Contraindications :

 

 

Contraindications

The LAP-BAND System is not right for you if:

• You have an inflammatory disease or condition of the gastrointestinal tract, such as ulcers, severe esophagitis, or Crohn's disease.
• You have severe heart or lung disease that makes you a poor candidate for surgery.
• You have some other disease that makes you a poor candidate for surgery.
• You have a problem that could cause bleeding in the esophagus or stomach. This might include esophageal or gastric varices (a dilated vein). It might also be something such as congenital or acquired intestinal telangiectasia (dilation of a small blood vessel).
• You have portal hypertension.
• Your esophagus, stomach, or intestine is not normal (congenital or acquired). For instance you might have a narrowed opening.
• You have or have experienced an intra-operative gastric injury, such as a gastric perforation at or near the location of the intended band placement.
• You have cirrhosis.
• You have chronic pancreatitis.
• You are pregnant. (If you become pregnant after the BioEnterics LAP-BAND® System has been placed, the band may need to be deflated. The same is true if you need more nutrition for any other reason, such as becoming seriously ill. In rare cases, removal may be needed.)
• You are addicted to alcohol or drugs.
• You are under 18 years of age.
• You have an infection anywhere in your body or one that could contaminate the surgical area.
• You are on chronic, long-term steroid treatment.
• You cannot or do not want to follow the dietary rules that come with this procedure.
• You might be allergic to materials in the device.
• You cannot tolerate pain from an implanted device.

 

Your Motivation

While the LAP-BAND® System is an effective treatment for morbid obesity, the pounds do not come off by themselves. The LAP-BAND® System is an aid to support you in achieving lasting results by limiting food intake, reducing appetite and slowing digestion. However, your motivation and commitment to adopt a new lifestyle are extremely important for long-term weight loss. New eating habits must be adhered to for the rest of your life. Exercise is an equally important component of a changed lifestyle.

Risks of Lap-Band Surgery

A brief description of relevant contraindications, warnings and adverse events of the LAP-BAND® System

Indications: The LAP-BAND® System is indicated for use in weight reduction for severely obese patients with a Body Mass Index (BMI) of at least 40 or a BMI of at least 35 with one or more severe co-morbid conditions, or those who are 100 lbs. or more over their estimated ideal weight.

Contraindications: The LAP-BAND® System is not recommended for non-adult patients, patients with conditions that may make them poor surgical candidates or increase the risk of poor results, who are unwilling or unable to comply with the required dietary restrictions, or who currently are or may be pregnant.

Warnings: The LAP-BAND® System is a long-term implant. Explant and replacement surgery may be required at some time. Patients who become pregnant or severely ill, or *****quire more extensive nutrition may require deflation of their bands. Patients should not expect to lose weight as fast as gastric bypass patients, and band inflation should proceed in small increments. Anti-inflammatory agents, such as aspirin, should be used with caution and may contribute to an increased risk of band erosion.

Adverse Events: Placement of the LAP-BAND® System is major surgery and, like any surgery, death can occur. Possible complications include the risks associated with the medications and methods used during surgery, the risks associated with any surgical procedure, and the patient’s ability to tolerate a foreign object implanted in the body.

Band slippage, erosion and deflation, obstruction of the stomach, dilation of the esophagus, infection, or nausea and vomiting may occur. Reoperation may be required.

Rapid weight loss may result in complications that can require additional surgery. Deflation of the band may alleviate excessively rapid weight loss or esophageal dilation.

Please Note: Not all contraindications, warnings or adverse events are included in this brief description. More detailed risk information is available at

www.lap-band.com or 1-877-LAP-BAND.

Risks from lapband.com

What are the general risks?
Using the LAP-BAND System includes the same risks that come with all major surgeries. There are also added risks in any operation for patients who are seriously overweight. You should know that death is one of the risks. It can occur any time during the operation. It can also occur as a result of the operation. Death can occur despite all the precautions that are taken. There is a risk of gastric perforation (a tear in the stomach wall) during or after the procedure that might lead to the need for another surgery. In the U.S. clinical study this happened in 1% of the patients. There were no deaths during or immediately after surgery in the U.S. study. Your age can increase your risk from surgery. So can excess weight. Certain diseases, whether they were caused by obesity or not, can increase your risk from surgery. There are also risks that come with the medications and the methods used in the surgical procedure. You also have risks that come from how your body responds to any foreign object implanted in it. Published results from past surgeries, however, indicate that LAP-BAND System surgery may have fewer risks than other surgical treatments for obesity.

Patients can experience complications after surgery. Most complications are not serious but some may require hospitalization and/or re-operation. In the United States clinical study, with 3-year follow-up reported, 88% of the 299 patients had one or more adverse events, ranging from mild, moderate, to severe. Nausea and vomiting (51%), gastroesophageal reflux (regurgitation) (34%), band slippage/pouch dilatation (24%) and stoma obstruction (stomach-band outlet blockage) (14%) were the most common post-operative complications. In the study, 25% of the patients had their band systems removed, two-thirds of which were following adverse events. Esophageal dilatation or dysmotility (poor esophageal function****urred in 11% of patients, the long-term effects of which are currently unknown. Constipation, diarrhea and dysphagia (difficulty swallowing****urred in 9% of the patients. In 9% of the patients, a second surgery was needed to fix a problem with the band or initial surgery. In 9% of the patients, there was an additional procedure to fix a leaking or twisted access port. The access port design has been improved. Four out of 299 patients (1.3%) had their bands erode into their stomachs. These bands needed to be removed in a second operation. Surgical techniques have evolved to reduce slippage. Surgeons with more laparoscopic experience and more experience with these procedures report fewer complications.

Adverse events that were considered to be non-serious, and which occurred in less than 1% of the patients, included: esophagitis (inflammation of the esophagus), gastritis (inflammation of the stomach), hiatal hernia (some stomach above thediaphragm), pancreatitis (inflammation of the pancreas), abdominal pain, hernia, incisional hernia, infection, redundant skin, dehydration, diarrhea (frequent semi-solid bowel movements), abnormal stools, constipation, flatulence (gas), dyspepsia (upset stomach), eructation (belching), cardiospasm (an obstruction of passage of food through the bottom of the esophagus), hematemsis (vomiting of blood), asthenia (fatigue), fever, chest pain, incision pain, contact dermatitis (rash), abnormal healing, edema (swelling), paresthesia (abnormal sensation of burning, *****ly, or tingling), dysmenorrhea (difficult periods), hypochromic anemia (low oxygen carrying part of blood), band system leak, cholecystitis (gall stones), esophageal ulcer (sore), port displacement, port site pain, spleen injury, and wound infection. Be sure to ask your surgeon about these possible complications and any of these medical terms that you dont understand.

Is there a chance the device will need to be removed?
The LAP-BAND System is a long-term implant, but it may have to be removed or replaced at any time. For instance, the device may need to be removed to manage any adverse reactions you might have. The device may also need to be removed, repositioned or replaced if you arent losing as much weight as you and your doctor feel you should be losing.

What are the specific risks and possible complications?
Talk to your doctor about all of the following risks and complications:

• Ulceration
• Gastritis (irritated stomach tissue)
• Gastroesophageal reflux (regurgitation)
• Heartburn
• Gas bloat
• Dysphagia (difficulty swallowing)
• Dehydration
• Constipation
• Weight regain
• Death

Laparoscopic surgery has its own set of possible problems. They include:

• Spleen or liver damage (sometimes requiring spleen removal)
• Damage to major blood vessels
• Lung problems
• Thrombosis (blood clots)
• Rupture of the wound
• Perforation of the stomach or esophagus during surgery

Laparoscopic surgery is not always possible. The surgeon may need to switch to an "open" method due to some of the reasons mentioned here. This happened in about 5% of the cases in the U.S. Clinical Study. There are also problems that can occur that are directly related to the LAP-BAND System:

• The band can spontaneously deflate because of leakage. That leakage can come from the band, the reservoir, or the tubing that connects them.
• The band can slip.
• There can be stomach slippage.
• The stomach pouch can enlarge.
• The stoma (stomach outlet) can be blocked.
• The band can erode into the stomach.

Obstruction of the stomach can be caused by:

• Food
• Swelling
• Improper placement of the band
• The band being over-inflated
• Band or stomach slippage
• Stomach pouch twisting
• Stomach pouch enlargement

There have been some reports that the esophagus has stretched or dilated in some patients. This could be caused by:

• Improper placement of the band
• The band being tightened too much
• Stoma obstruction
• Binge eating
• Excessive vomiting

Patients with a weaker esophagus may be more likely to have this problem. A weaker esophagus is one that is not good at pushing food through to your stomach. Tell your surgeon if you have difficulty swallowing. Then your surgeon can evaluate this.

Weight loss with the LAP-BAND System is typically slower and more gradual than with some other weight loss surgeries. Tightening the band too fast or too much to try to speed up weight loss should be avoided. The stomach pouch and/or esophagus can become enlarged as a result. You need to learn how to use your band as a tool that can help you reduce the amount you eat.

Infection is possible. Also, the band can erode into the stomach. This can happen right after surgery or years later, although this rarely happens.

Complications can cause reduced weight loss. They can also cause weight gain. Other complications can result that require more surgery to remove, reposition, or replace the band.

Some patients have more nausea and vomiting than others. You should see your physician at once if vomiting persists.

Rapid weight loss may lead to symptoms of:

• Malnutrition
• Anemia
• Related complications

It is possible you may not lose much weight or any weight at all. You could also have complications related to obesity.

If any complications occur, you may need to stay in the hospital longer. You may also need to return to the hospital later. A number of less serious complications can also occur. These may have little effect on how long it takes you to recover from surgery.

If you have existing problems, such as diabetes, a large hiatal hernia (part of the stomach in the chest cavity), Barretts esophagus (severe, chronic inflammation of the lower esophagus), or emotional or psychological problems, you may have more complications. Your surgeon will consider how bad your symptoms are, and if you are a good candidate for the LAP-BAND System surgery. You also have more risk of complications if youve had a surgery before in the same area. If the procedure is not done laparoscopically by an experienced surgeon, you may have more risk of complications.

Anti-inflammatory drugs that may irritate the stomach, such as aspirin and NSAIDs, should be used with caution.

Some people need folate and vitamin B12 supplements to maintain normal homocycteine levels. Elevated homocycteine levels can increase risks to your heart and the risk of spinal birth defects.

You can develop gallstones after a rapid weight loss. This can make it necessary to remove your gallbladder.

There have been no reports of autoimmune disease with the use of the LAP-BAND® System. Autoimmune diseases and connective tissue disorders, though, have been reported after long-term implantation of other silicone devices. These problems can include systemic lupus erythematosus and scleroderma. At this time, there is no conclusive clinical evidence that supports a relationship between connective-tissue disorders and silicone implants. Long-term studies to further evaluate this possibility are still being done. You should know, though, that if autoimmune symptoms develop after the band is in place, you may need treatment. The band may also need to be removed. Talk with your surgeon about this possibility. Also, if you have symptoms of autoimmune disease now, the LAP-BAND System may not be right for you.

Removing the LAP-BAND System
If the LAP-BAND System has been placed laparoscopically, it may be possible to remove it the same way. This is an advantage of the LAP-BAND System. However, an "open" procedure may be necessary to remove a band. In the U.S. Clinical Study, 60% of the bands that were removed were done laparoscopically. Surgeons report that after the band is removed, the stomach returns to essentially a normal state.

At this time, there are no known reasons to suggest that the band should be replaced or removed at some point unless a complication occurs or you do not lose weight. It is difficult, though, to say whether the band will stay in place for the rest of your life. It may need to be removed or replaced at some point. Removing the device requires a surgical procedure. That procedure will have all the related risks and possible complications that come with surgery. The risk of some complications, such as erosions and infection, increase with any added procedure.

 

Biggest mistake I ever made.  I would never suggest a band to anyone.

They are a short term, ineffective solution to a life long problem.  The band makers no longer claim they last for life. Most of our old timers around here are already on their 2nd bands.

Remember, most ins co's are going to a once in a life time WLS.  When your band eventually fails you are very likely to be self pay for your revision.

I would go with something proven to be far safer, a sleeve.  I see no logic in getting a device proven to be ineffective, short term, and dangerous vs. getting the right surgery type the first time that is the safest surgery type long term, least risk and complications, and 1000x easier to live with.  Not to mention far more effective.

I don't have a band but none of the surgeries are permanent with the exception of permanently keeping your insides rearranged. I'd rearrange mine any day! Lol

Any surgery that makes a pouch will stretch (like my RNY), bodies will learn to re absorb some in surgeries that diminish absorption. In those ways, the band is more permanent than more radical surgeries...it's still available for use. I'm regaining with no tool to use.

On the other hand, weight loss with the band is less and more variable and it seems to either be loved or hated. If you have a ton to lose, I'd recommend DS from the start. If not, go with your gut.

You mentioned:

Any surgery that makes a pouch will stretch (like my RNY), bodies will learn to re absorb some in surgeries that diminish absorption. In those ways, the band is more permanent than more radical surgeries...it's still available for use. I'm regaining with no tool to use. 

You are CORRECT, if the band is well managed and you have great aftercare, most complications can be avoided, MOST complications are due to being too tight and eating too much, but of course there are other issues that can happen, which are listed in the list of contradictions.

I picked the band because my sister had a "stomach stapling surgery years ago, and it worked great for about 3 years, and if she wanted to continue to lose weight it would have been through dieting and exercising because her stomach stretched back out, she still does not eat huge meals, but her meals are too large for her "tool" to help her with weight loss.

Any type of procedure that staples the stomach WILL STRETCH.....

Any type of surgery that last for a LONG time is MORE RADICAL...such as the DS, and the DS comes with its own set of high risks, banded procedures such as Fobi Pouch, lap band, or Band with Bypass tend to keep weight down for long periods of time...but there is still risk for erosions, but that can be managed with using the precautions to minimize the erosion risk, but erosions are rare in most banded folks anyway.

 

 

 

Hello. I am a Lap Band girl. I had a leak a year and a half ago. I put of 30 lbs. and had to have the tubing and port replaced. I now have a small hernia and have gained another 20 lbs. My surgeon is recommending the sleeve (flavor of the month - some say). I am having a hard time deciding if I want a new band or want to go for the sleeve.

So, the bottom line is this...

I lost up to 120 with the band. I now have lost 60 due to my own poor eating habits and problems with the band. I still love my band!

Hi Donna,

 

Long time no see, sorry to hear about your band leak! I had my band replaced last November, and I thought about the Sleeve, but after extensive research (outside this board) I learned that the Sleeve will stretch back out in most folks within 2-4 years, some quicker than others.

edited to add:  I had a hiatal hernia too, that was causing me pain and reflux, I had to change surgeons, my old surgeon wanted to Sleeve me too, but I refused and found another surgeon in PA, he fixed my hernia, removed my old band and gave me a new band, I now have great restriction with no reflux, I am happy I gave the band another chance.

Also Band to Sleeve revisions do NOT do as well as virgin Sleeves, could be scar tissue, not sure , but MANY have reported they have tighter restriction with the band than the Sleeve, but overall many say they like the natural feeling the Sleeve gives them of not getting food stuck.

Also most importantly people on this board do not mention Hypoglecemia that is starting to occur in many long term Sleevers, some don't get it until 5 years post op and  it can be deadly and debiliting...I asked my surgeon about this the last time I was there and he confirmed that many Sleevers suffer from this, not sure why it's not discussed on these boards, many will just say they have an reaction to "sugar"...but long term it's a lot more to just I can't tolerate sugar....

Here is a clinical trials study that is going on right now....with both long term Bypass and gastric Sleeve patients....

At least if you decide to get the Sleeve you will be well informed....and bottom line is you will have to work your Sleeve just like the band, but without the "safety net of any needed fills long term"...I know we always want to believe the grass is always greener, but it may not be...and could be just the "flavor of the month" just like the band was years ago...AND WE know the results from that...at LEAST I know the band...LOL...

hypoglycemia Clinical Trials Bypass and Sleeve link

http://clinicaltrials.gov/show/NCT01581801

Nana,

I was so happy to see you are still visiting the boards. Thank you for the information on RHG. I did not know that it happened to sleeve patients. That scares me to death. I need to keep researching!

Thanks again.

Scared me too..LOL...

Some call it dumping syndrome, but the Sleeve is no longer considered a Restrictive only procedure because it causes "dumping like Hypoglycemia symptoms in many patients.

Here are more links from the NIH...

http://www.ncbi.nlm.nih.gov/pubmed/21647622

 

Here is a lady describing her "dumping like syndrome"

http://www.youtube.com/watch?v=7VrJis4rTEg