Looking for bands to sleeve revision

Briefly, I was banded in May 2005, and only lost 46lbs in the first 15 months or so and then the weight loss stopped.  Unfortunately, my band was never destined to work properly because the locking mechanism was not connected  and over time the band opened up and eventually caused a massive erosion into my stomach.     My band was removed in Oct 2007 and I have been steadily regaining much of the weight I had lost since then.   I understand that there could be some difficulties performing the sleeve surgery if there is severe scarring, but my surgeon has told me that as well creating the staple line, he also over sews the line to help prevent leakage.   If there is anyone out there who has revised from eroded band to sleeve, or who has had severe scarring following band removal to sleeve, I would be interested to hear how it went for you and if there were any difficulties with your surgery or recovery. Many thanks Marion from NZ

I had band to vsg surgery one year ago.  At the time of the surgery, the doc found that I had a hole in my stomach (erosion) and I had been treated for a severe infection for several months unsuccessfully, via IV antibiotics.  The doc said that the surgery was difficult, but I did not find that the recovery was any different than with the band.  Email me privately if you want to talk.  You can also read my profile on OH for more details about my issues that lead to band removal. 

Hi KB Thanks for your response.   Your symptoms were the mirror of my own, especially with the persistent  infection in the port area.  It was fortunate that you were able to get your revision at the same time as your band removal in spite of the erosion.  Unfortunately that was not an option for me because virtually all of my band had worked its way into my stomach, but onward and upward from here, this time in four weeks I will have my new sleeve!   Marion

Hi Marion

I am a lapband to sleeve revision. Had the band for almost 5 years. I was a one step revision and that is actually more difficult than removing the band, waiting and then having the sleeve. I had a lot of adhesions and scar tissue and it took 4 hours to remove and sleeve me. I did just fine.

Babs

Thanks for your response Babs, I remember you from the band forum in the early days of my banding back in 2005.   I am glad that you have had a good result so far with your VSG.   I was interested that you also had lots of adhesions and scar tissue so I have learned something new.  It must be quite common to find that with band to sleeve revisions, whether eroded or not.   It took my surgeon over 3 hours to remove my band and repair the damage to my stomach, so I hope that the revision to VSG goes smoothly in four weeks. Of the two surgeries that you have had (looking at before you had problems with your band) do you find the sleeve easier to work with on a daily basis than the band?   Thanks in advance. Marion

Hi Marion,

THe sleeve is much easier than the band (and maintenance free!! Yeah!) once you get past the first month. I was on liquids for 3 weeks and since the new sleeve tummy doesnt recognize that you no longer have ghrelin production, head hunger and real hunger the first month for me was a real tangible thing and I had a hard time with that. I have some food intolerances since I have been slee I felt like I was starving and then when I would have something (1 or two ounces) I would get full and then frustrated I couldnt eat more. My new tummy cant handle salsa, tomato sauce or any fatty or greasy foods. If I eat too much or too fast, I feel very nauseated. Other than this, eating is very normal now than compared to my life with the band. I can eat anything in moderation (4 oz) and I am done.

Good luck with your surgery. I am sure that you will have an uneventful and easy surgery since your stomach had lots of time to recover from banding.

Babs

We all have severe scarring from banding, the scars and adhesions are what hold the band in place.  The issue is where the erosion was.  If the erosion scarring is such that the staple line goes right down the eroded portion of your stomach then it may be a problem because you will be at huge risk for a leak. With any revision from band to sleeve/RNY/DS you are at additional risk for perforation, bleeding, infection, and leaks. So it is critical that you take a long hard look at whatever surgeon you choose and not base your decision on trust and that you like him, but instead his track record. Not saying you are doing this...  I have no idea who you will be using.  But many make the mistake of "really liking their doctor" and they believe that because he is so nice he is really good.  Not necessarily true.  Look at the facts.  How many revisions from band to sleeve has he done?  How much staple line experience does he have?  Can he do bypass?  (Harder staple line)  How many leaks has he had? (Not all leaks are the surgeon's fault but if he has quite a few, it may be his fault)  Does he oversew the suture line or use glue?  Or nothing but a staple line?  Does he have at least 500 staple lines under his belt? (Add sleeves and bypass to get staple line experience)  Which leak tests does he do?  All surgeons use the air bubble test during surgery but what does he do afterwards?  Does he use a drain?  This is especially important for revision folks because it shows what is going on INSIDE before symptoms even hit.  Does he do a dye test with a drain?  Does he do a fluoroscopy test to check for microperforations?  If he does, does he use barium or a water based contrast?  Barium is very dangerous if there is a leak but it's cheap so doctors use it.  Water based contrast is very expensive but it's much safer for the one getting the leak test.