Band Failure/ Erosion

I had the Gastric band procedure in 2007, I had great success with the band for 8 years until the band eroded and had to be removed, now I am looking into revision surgery. I have heard of  conversion to the sleeve but my surgeon is against that surgery as a revision, he is recommending revision to the Gastric Bypass. I want to explore all of my options before I go back "under the knife".

since having the band removed my kidneys functions have worsened and I have gained 80 lbs (mostly fluid retention) in a couple of months so naturally I want to get this revision ASAP, but my Surgeon says I must wait 6 to 8 months prior to doing a revision surgery.

any advise would be greatly appreciated.

When I saw a new surgeon about getting a Lap Band revision, I originally thought a Sleeve would be the best way to go, as my DH's boss had the same issues as I had with my band, and he revised to a sleeve and had a HUGE success.

What changed my mind was when the doctor discussed the weight loss facts surrounding the different procedures. I actually have the page here in front of me, and will type it here for you:

 

Gastric Bypass:

- 75% Excess Weight Loss with 60% EWL, average even 10 after surgery.

- Better weight loss than sleeve or band in short term and long term

- Excellent hunger control

- Superior long term weight loss versus sleeve and band

 

Gastric Sleeve:

- Averages 70-75% Excess Weight Loss

- Removes approx. 3/4 of stomach to create a long narrow "child like" stomach that is shaped like a sleeve

- Excellent Hunger Control

- No significant changes in digestive process

- Cannot be reversed, although can be converted to other procedure

- Very low complication rate

 

Lap/Band:

- Averages 40% Excess Weight Loss

- EWL may be has high as 50% in patients with BMI of 45 or less

- Requires monthly adjustments for 1st 4-6 months then as needed (typically 8-10 within first year)

- High re-operative rate of 39% within 5 year period

- Difficult to keep functioning long-term due to "wear and tear" on the stomach

 

For me, my failure with the lap/band is that I was still hungry even after my pouch was full, so the RNY seems like the best alternative for me, since the part of the stomach that controls hunger is bypassed.  Conversely, since you had a high success chance with the band, then perhaps the sleeve is a good choice!  Hopefully some of this is helpful... :)

Unfortunately neither the RNy or Sleeve guarantee that your hunger will be gone.  With RNY - my hunger can be controlled by a very strict diet. If I eat carbs - I get really really hungry... Since they did not removed my stomach - it still sits there making lots of hunger hormones. 

VSG - they remove most of the stomach that produces the hormones. 

 

I had RNY -if I could go back - i would get the sleeve. 

Unfortunately neither the RNy or Sleeve guarantee that your hunger will be gone.  With RNY - my hunger can be controlled by a very strict diet. If I eat carbs - I get really really hungry... Since they did not removed my stomach - it still sits there making lots of hunger hormones. 

VSG - they remove most of the stomach that produces the hormones. 

I totally agree with Hala the sleeve is the way to go unless for some reason your kidney issue is a factor. Latest studies show that the sleeve is just as successful as the RNY at 5 yrs out so there goes that theory. Plus with the sleeve you don't have to deal with malabsorbtion issues like with the RNY. Such as the loss of the calorie malabsorbtion, after 12-24 mos. it goes away and you are left with life long vitamin malabsorbtion but full calorie absorbtion! Plus I would think if you are having kidney problems they would want you to have full absorbtion of all your nutrients and medications. I would most definatly get a 2nd maybe even 3rd opinion on the situation. Myself I would go sleeve and it can be revised to a DS if the sleeve isn't working well enough. If you get RNY you would still only be able to revise to a DS but it is a much more complicated and dangerous surgery to revise from the RNY top DS than it is from the sleeve to DS. You need more opinions and more explanations of the whys on revision options. Best of luck to you!

 

from what I understand ,  after having a Band, there is quite a bit of scar tissue that forms around the area and the tissue would have to be removed and then after a certain time period they would have to explore and see if the sleeve procedure could be performed at that point, so they say that the sleeve is a good option if it is performed "initially" but it is a more dangerous /complicated surgery if it is a revision surgery. (if I understand that correctly)

 

I had the band removed and the sleeve done at the same time....also had a hernia and scar tissue removed as well. My surgeon had no doubts all  could be done at once, yes I feel like I got hit by a truck but glad it was done at once. Maybe a second opinion is in order? Could be that the kidneys are the issue, I didn't have kidney issues

I revised from Band to RNY on Monday. I chose RNY because it reduces incidences of reflux, and is a more "established" surgery. 

But everyone's needs are different and only you can know what will help you with long term success.