Lap Band Revision Options

Hello!  I had the lapband last August.  I initially lost a good amount of weight as I had restriction from the very beginning before having fills.  I had 1 fill of 1 cc and could barely swallow.  I had it reduced to .5 cc in a 4cc band.  I kept that amount for a while and then had more added again.  Again I was not keeping food down, had swallowing issues and discomfort.  I went in for an upper GI and my band was unfilled.  I was in heaven when it was unfilled but I went from having lost 60 pounds in 4 months to gaining back close to 20 in the 2 weeks following the removal of the fluid from the band.  My doc told me to come back in a month to get refilled and I never called him back.   I had hoped when I went in for the upper GI that he would find something wrong and I could get a revision but all he found was some slight swelling of the esophagus.  Well, now I've been without a fill for 2 months and I'm throwing up close to every day (5 out of 7 days a week).  Some days I throw up my morning coffee and some days I can eat amounts close to what I ate before surgery.  I never know when or what will stay down and I've gone back to my old habits of eating snack food and smooties since they always go down without coming back up. The doc has been calling me, yes my doc has actually called me, and I've been avoding him.  I mean I didn't figure there was anything he could do.  I'm too low in BMI now to be a candidate for surgery again and I'm definitely not going back in for a fill.  He talked to me today a little bit and didn't mention revision per se but said there are lots of things he can do and I can't put my head in the sand and pretend it's going to get better.  He is right so I'm going in tomorrow for another upper gi. My question is, what are the options after a failed lapband?  I've read a little about DS and several people on here have made comments about RNY.  To be honest, I'm a sugar person.  I will say that on the band when I ate chkn initially and threw up chicken I stopped wanting chicken so I'm thinking if sugar makes me sick, (dump) I'll change my taste for sugar and not want it anymore.  I always thought it was the amounts I ate at meal time btu I think my weight problem is more related to snacking episodes.  I'm 220.  Was 260 and got down to 203 with the band.  I've gained back 17, all of which was in the first 2 weeks after having my band unfilled. Would some of you share your experiences or lead me to your profiles to read about them?  I don't think anything will happen quick but I'd like to know a little bit before going in to see him. Thanks! Laurel

First and foremost I hope that you will do something to get your life back to normal. I can understand just how miserable this must be for you. Right now I am hoping to have a revision from my Lapband to RNY. My doctor thinks that it would be the best solution for me. I just want to wish  you good luck and good health no matter what path you choose.

I really understand how you're feeling, I'm not sure I have any good advice. I, too had an upper GI done and then I was approved for a revision from band to RNY. Maybe when you have the next upper GI they should put some of the fill back in to see how your band functions with the fill in place, maybe that can shed a different light on things. But having swelling of the esophagus should  cause an alarm. Since having this band I believed my eating habits has gotten worse, it has drawn me more to the wrong foods, but that is changing. I'm just glad I have a second chance with WLS. I pray you will also. Good Luck Tonya

We must talk! I am in the process of preparing for revision. I have a tenative date for 8/15

Your options include: VSG... restrictive only operation, works like the Band was supposed to.  Removes 85% of your stomach... and the portion that produces ghrelin (hunger horomone).  Pylorus left in tact.  DS... VSG + malabsorption.  Best weight loss long term; however you need to be vigilant with protein and vitamins for life.  Blood work for life.  Has most normal eating post-op.  Absorb only about 20% of the fat you eat... so many DSers eat high -fat.  Can be done with a longer common channel (150 cms+) to be less malabsorptive. RNY... which you know about.    About 75% of people dump, but not everybody does.  Also for many, dumping goes away after one year.  So, if you're counting on dumping as a long-term strategy, it may not work.  (Of course, it could as well. :)) MGB.  Mini Gastric Bypass.  ONly performed be a few surgeons.  Cash pay only.

What do you call a gastric bypass and malabsorption ? They equal what ? I had a gastric bypass in 1997 and know they are doing a revision of that buy cutting the small instestine down. So is that's restrictive and malasorption is that more severe than a DS ? I am just wondering....

A gastric bypass/RNY... is usually considered both restrictive (due to the pouch) and malabsorptive.. although not as malabsorptive as a DS because less is bypassed.

Hi Laurel,

I am a 5 year bandster to gastric sleeve revision. Read my profile. I was very successful with lapband until the long term complications started.

It sounds like you have a band slip. You could have caused the slip with all the vomiting in the last few months or the slip may have already been there from a previous vomiting session. If your band is empty and you are still vomiting, you need to see your doc. YOu have the following options:

Continue to do nothing and avoid doc calls and possibly do damage to your esophagus.

Go see your doc and see if all the vomiting has caused a slip which would justify revision surgery to another band or something else.

Your present BMI has nothing to do with qualifying for another surgery if you have band related complications. You should either be able to get another band or revise to something else. Revisional surgery is different than getting approved for an original surgery. HOwever, after testing (endoscopies or fluroscopies or motility testing) if they find nothing wrong with your band, then it would be hard to convince insurance that you need to have it removed and revised. I hope this makes sense to you.

I wish you luck. Please do something about your situation before you do some permanent damage to your esophagus.

Babs

No saline and you are still throwing up? Yikes. When my doctor took all my saline out it was like I didnt even have a band. The only reason I ever lost weight was because I threw up everything I ate because food was always getting stuck when I had restriction. I could never find my "sweet spot"  though. I am revising to RNY soon. The only advice I can give is talk to your doctor and see what he says. Good luck and keep us updated on what you decide to do!

Hi, I am having a revision done on June 24th and I am very excited, this started out for me preping for the stomaphyx, however after 2 appeals to my health insurance, my doctor suggested a full revision and I said wonderful that is what i was thinking.  I had the bypass done in April of 2003 and I have gained back 50 #'s and tried the Weigh****chers thing when that did not work I decided to get a 2nd opinion when my own doctor would not advise me on what i needed to do to help the weight back off.   Please feel free to contact me with any questions. Melissa