Mayo Clinic no longer offers gastric bands

There are plenty of banded and formerly banded people out there who did not keep their band too tight, eat around the band and have exercised will power and discipline in their WLS journey and are suffering horrible consequences.  I signed consent for removal last week that included gastrectomy, esophectomy, and a long list of other potential options.  One of our members on FB lost the entire bottom of her stomach last week, including the pylorus due to necrosis below her unfilled band.  

In my lifetime (63 years) I had a dozen or so surgeries before being banded.  I've added 3 and may have up to 3 more if I decide to revise.  If my motility issues don't fully resolve I will have surgery to take down the HH repair and redo it.  My medical bills for the last three years are over $150k, more than in the entire 60 years previous.  I was compliant.  I had 2 fills, 3 cc and .5 cc.  My symptoms of complication started almost a year after my last fill...my stoma was almost completely closed due to scar tissue under the band.  Unfiilling exacerbated my symptoms, waking up sucking acid into my lungs, chest pain fom spasms, constant palpitations from food in my esophagus irritating and crowding my heart.  The last 6 months, I might keep 2 meals a week down.  I lived on ice cream and cream soups and lost a pound a week.  

As I crossed the "onderland" milestone, there was no celebration.  I don't credit my band with that "achievement", band induced achalasia gets the credit.

As Dr Pellegrini told me last week, "...if you had NO symptoms of this condition before the band, then it's the band causing it.  Achalasia is a RARE disease that develops over decades or is congenital.  It never develops to end stage in under 9 months".  Achalasia occurs in non-banded population in 1:100,000 people.  That's .00001%.  In banded population it's occurring in up to 5% and there are some who think its much higher.  .00001% vs 5%. 1/100,000 or 1/20.  Big difference.

why risk it?

~~Are you saying the Sleeve/Bypass has life long lasting restriction?~~

No, I meant exactly what I wrote.  When bypass has to be revised at the same rate as bands at the six year point then I will believe bands are safer than bypass.  And please note, I was doing my best to gives bands the benefit of the doubt because I don't like bypass, not even a little.  I believe long term bypass is not a great option and not worth the risk.  Ask me about sleeves and DS long term and revision rates, I was doing the band favors by comparing it to bypass.

I have been sleeved for 5 years.  Today when it comes to dense protein I can eat about 3.5 ... MAYBE 4oz.  My sleeve is far less likely to dilate vs. your banded pouch and that is because with my sleeve the fundus of my stomach was removed.  The fundus IS the stretchy part.  The portion that remains is muscular and less likely to dilate.  But what if my whole stomach doubles in size!?!?  Maybe I can eat 8oz,  If I regain over 100# because I can eat 8 oz then it isn't my sleeve that  is the problem, it's ME.  Anyone can eat around any surgery type, that is on the person and not the surgery type.  What is not the fault of the person is mechanical problems and bands are loaded with them.

I remember one lady that really drove home a point for me a few years ago.  She had standard issue band problems.  Top that off with she got food poisoning and vomited her way to a severe slip that required her to remove her band.  She was honest about the slip but she kept repeating over and over again, it wasn't the band.  It was HER.  The band behaved exactly as it should it was her fault for getting food poisoning.

???  What???  Since when is getting food poison the patient's fault?  I mean, it happens.  It isn't something we set out to do!  Nobody waits for a nice hot day and takes their mayo out for a visit to the sun for six hours so they can consume it and get food poisoning.  But when the band is so unforgiving that you risk losing it with a violent episode of vomiting if there is a fault here, it doesn't belong to the person.  Have you ever in your life had a violent vomiting episode?  Well, with a band you are not permitted to do that again, you risk losing your entire surgery type.  Stomach viruses, food poisoning, seeing a dead decaying body... it all produces vomiting and you seriously risk your band when you do that.  Who can promise to never vomit again?

There is a learning curve to chewing and eating with any WLS type and more so with bands and bypass vs. sleeves and DS.  Wait until the first time you ever get stuck and I dare you not to vomit and sometimes for hours trying to get unstuck.  Go on vacation and dare to be away from your surgeon during a stuck episode.  In the ER all they will do is give you IV fluids while you hurl your heart out.  They don't know what to do and by the time they figure it out, find a bariatric surgeon willing to come in and unfill you in the middle of the night the damage is done.  Please understand, I am not referring to rare issues that hardly ever happen.  I am talking vomiting, human beings DO that.  WLS folks do that MORE.  What is your plan to not vomit again?  I'm not being snarky, I am sincere.  What is your plan?

You can get an unfill but face it, you don't know you are going to vomit a week ahead of time.  By the time you know you have a serious problem the issues have already started.

Scar tissue tends to grow under the band causing more restriction than people want.  You can unfill the band but that doesn't stop the added restriction from the scar tissue.  It still continues to grow.  What is your plan to prevent your body from doing what it is supposed to do and engulf a foreign object in scar tissue?

The band is a high pressure device wrapped around a very soft piece of stomach right below your esophagus.  Your body was not designed to put a ring around it and over time that high pressure device starts harming your esophagus.  I have esophageal damage from the band.  I will have forever, non stop, constant reflux due to the damage.  Bypass should have been my solution but I will never have bypass.  I took the chance on a sleeve and we had hoped removing the band would resolve the esophageal issues.  It did not.  But, I was willing to take the risk and go for a sleeve anyway and I am okay with that.  Bypass wasn't a promise the same thing would not be the end result.  This begs the question, what is your plan to prevent the high pressure (unfilled) band from harming your esophagus?

Erosion, nobody knows what causes erosion.  Oh, we do know that for a small number of people that have their band placed far too tight for far too long can erode, but that is not the primary cause of erosion.  When Realize came out with their band they advertised it prevented erosion.  I remember laughing at that because if nobody knows what causes erosion, how are they going to prevent it?  If you look at the non Allergan 'bought and paid for' studies, erosion is higher today than previously.  Since we don't know what causes erosion how will you prevent it?

Vagus nerve damage.  There is a nerve that runs throughout your body and controls organs and all sorts of things.  That nerve runs directly under the band.  Do you really think you can compress such a critical nerve in your body and it won't fight back?  One lady fainted every single time she ate.  Vagus nerve damage.  Another had massive heart issues.  Vagus nerve damage.  The majority of vagus nerve damaged people have pain.  Google left shoulder pain/vagus nerve and see what you come up with.  What is your plan to prevent this?

The sweet spot does not exist in most people.  It just plain doesn't  It didn't for me and it does not for most.  I was either able to eat a porterhouse steak or, I couldn't swallow my own saliva.  The greater majority of my banded life was unfilled.  You have to assume you will have no sweet spot.  If you happen to have one, good for you!  This nonsense about not having a sweet spot until weight loss is just that.  Nonsense.  I have been reading boards like this for 7 years and I have yet to see someone make such a silly statement.  Most people need restriction to lose weight to begin with or we wouldn't have had surgery at all.  Honestly, with time the sweet spot is 10x harder to get, not easier.  Ask vets who had to have a total unfill for whatever reason and see what they say happened when they tried to start getting fills again.  There was no sweet spot.

I can go on all day long.  The bottom line is you can follow band rules all you wish, you can take every precaution but for most band problems there is no rule to follow to prevent them.

They have been trying to get bands right for over 40 years now and they still don't have it down.  First in the 70s it was the mesh band.  That didn't work.  Then the 80s the Molina band.  That didn't work.  Then the 90s the small  metal non adjustable ring.  That didn't work.  Then the 2000s and it was the small adjustable band.  That didn't work.  Now they have the mega adjustable band.  You know what?  Stats haven't changed in 40 years.  It is a concept that does not work.  But as long as people have a hope and a prayer as well as cash in hand they will keep selling them.  Well, except Allergan.  They know it is a dying product and that is why they have been trying to sell off the band for over a year now.

Your support group-  Consider this.  With ANY WLS type newbies from 0-6 months are in love with their surgery type and in love with their surgeon.  From 6-12 months they are figuring out that they are doing the work, not their surgeon but for banded folks they are still in love with their band.  From 12-18 months post op banding they are starting to feel the problems but the scale is moving so they will live with it.  From 18-24 months they are getting sick of the vomiting and complications.  The fills, unfills, esophageal spasms, not wanting to eat in public, sore throat, reflux... they are sick of it and considering their options.  From about 2 years post op they are revising to other surgery types or at least replacing their bands.  Most of the vets who do or used to post here have already had re-ops.  Maybe they should just have a zipper installed along with the band to make it easier for the surgeon.

~~From what I hear is if you keep the band way too tight while losing, and depend on the band too much, well you have issues, but if you use the band like a diet while losing that is the best approach and you have less or no complications.~~

Well, you didn't hear me say that.  I know there are people who did keep their bands too tight but that isn't the norm.  You literally can't keep it too tight for very long, when you do you can't drink water.  You can't eat ANY food, that can only last so long.  What you hear is people who are militant band defenders trying to find a way to make all the band problems the fault of the patient.  Most of my banded life I had no fill whatsoever.  One day I could eat anything I wanted in any quantity with an unfilled band and the very next day I couldn't swallow my own saliva.  We used to joke around on this board years ago that if we were to start doing torture to the enemy during a war we would band them, fill them just a tad too tight and leave them on an island somewhere.  There is nothing more miserable than being unable to eat or drink and especially when you are thirsty.  Try holding a glass of water and not sitting down in tears because you are so thirsty but it doesn't matter, tha****er isn't going down.  Think about that, do you really think people CAN willingly stay that tight for that long?  What REALLY happens is that when people are that tight, tight enough to cause an erosion they usually end up vomiting so much they slip before they have a chance to erode anyway.  You just can't stay tight for that long and keep your sanity and reality check here, you can only stay that tight before you dehydrate and die.

There is a band fan here that claims I abused my band, ate around my band, kept it too tight, slipped repeatedly, and got no aftercare.  Nothing could be farther from the truth.  I never had a slip, i never eroded, I never kept my band too tight, it was unfilled proably 90% of the time.  I was standing in my docs office at least every other week for the entire 18 months I was banded, my fills, unfills, and check ups were all done under fluoro.  I did not eat around my band, I lost over 100# in 10 months and got to goal in 10 months.  I used my treadmill daily and towards the end was up to 10 miles daily.  I was the poster child for banding or any other WLS for that matter.

~~But I see what you are saying many people just don't have the will power or discipline to not use the band so tightly,~~

Where in the world did you get that from?  *I* never wrote any such thing.  You are telling us what you want to believe from your support group.  Nothing remotely close to truth.  You want a band and so you are changing the words we write here and making them fit into the words you want to believe from your support group.

We are not here for our health, we are not here because we have nothing better to do.  We are not providing you with peer reviewed journal articles because it's fun.  We are not writing and rewriting the same information so it will sink in because we find thrill in it.  We are trying to tell you reality here.  When someone has WLS, for awhile they get sucked into this mind thing and your world revolves around diet, exercise, following rules, counting carb grams, weighing portion sizes, contemplating whether you should count fat grams or calories, researching which fats are the good ones, reading labels to the point that you don't need to read them you can recite them from heart.  If someone asks you how many carbs are in yogurt you ask which brand because you know them ALL.  It's this good, bad, freakish, mind numbing, exciting, depressing 'thing' you get sucked into because this time you really ARE going to do it the right way.  People that are still in that mode refuse to believe the band is anything but God's gift to fat people.  They can't risk it, they are devoting more to this than they have ever done before and they won't tolerate anyone telling them this might not work.  THOSE are the people YOU are dealing with at your support group.

~~Honesty, I am not too excited about any of them from all of my research, but at least with the Lap band you can get it removed if something goes wrong, that's what is so appealing to me.~~

When it comes to the band you NEED to be able to remove it because it WILL go wrong.  Ask the band makers!  Ask the fed govt!  Ask any 20 people you can find that are 10 years post op from banding.  You can remove it but you can't remove the damage.  If you are looking for safe then the sleeve is your pick.  Not the band.  If you are looking for best resolution of comorbidities and long term weight loss DS is your surgery.  What you really need to ask yourself is what value is there in removing the band AFTER it has already done the damage?  You don't get a warning a month ahead of time that this is it, the damage is being done.  You don't get a warning a month before your erosion, you lose all restriction and can't figure out why. The erosion has already happened!  What you are really writing here is that you want the option with the most mechanical problems so that after the damage is done you can have it removed and live with the consequences instead of getting a safer surgery type long term to begin with.

My whole point here is that there are no take backs.  You can't complain a few years from now that you didn't know the band was not going to last (on average) a few short years, you can't say you didn't know it would have all these complications and the highest regain of all surgery types, you can't make any of those claims.  You know this all up front and you want the surgery type that is least effective with the most complications.  That's FINE!  It is your choice, your body.  You have the right.  You won't have the right to say you didn't know full well this would happen.

Yep, you can get it removed but that doesn't mean you can get the damage it causes reversed.  Our band support group was disbanded as the banders were having problems.  If they are all together they can compared notes on how so many were having issues, separately we were still being told problems aren't common.  You might want to think about how many bands have been placed at your center and you found 3 that have been successful.

It is your choice!  Good Luck.

If you look at peer-reviewed studies comparing all FOUR forms of WLS, the Band has the lowest long-term, maintained weight loss, the Sleeve and the RNY are pretty closely tied, and the DS has the best of all.

The key words here are "long-term, maintained weight loss". Most people can lose a significant amount of weight with ANY form of WLS. Heck, most people can lose a lot of weight with the traditional "diet and exercise". It's keeping it off long-term that most of us suck at. And just how is a device that the manufacturer admits is only intended to last for ten years AT THE MOST going to help you with "long-term, maintained weight loss"?

Diets DO work---if you can stick to one for the rest of your life. Most of us can't.

Don't be like me, 3 surgeries in 3 years and now I have no help losing weight.  The concept of banding is inherently flawed, almost guaranteeing it will need to be removed in 3-8 years time.  

This is how I found it: mayoclinic.org, click on patient, click on health issue, b,bariatric surgery, types.  Only rny, vsg and ds are listed.  I copied and pasted the link directly from the navigation bar.  No typo.  It's current.

they also no longer do Lap Band surgery at Emory Hospital in Atlanta.  they will adjust them if you have one.  also they do remove quite a few of them though, go figure!

I know this is redundant, but are you utilizing Emory in your medical care currently.  I got action when I went to the University of Washington medical center.  They still do a few bands, but they have a world leader in researching esophageal dysmotilities and he was certain that my end stage achalasia dx was incorrect and it was the band causing my problems.

Good to know! I was unaware of that till this point. So glad that they won't be endangering their patients in this way with such a (generally) short term procedure!

I went to the informational secession on 06/18/13 at Mayo Clinic in Phoenix, Az.  And they do not offer the lap band any longer.  On 07/15/13 I met with the DOM (Director of Medicine) and she also stated that Mayo does not offer the Lap Band surgery any longer due to the failure rate that it has had.  I decided that I would go with the gastric sleeve.  I go back on July 25th to meet with a team of physicians to get this started.