Hi there,
I'm feeling for you! Have you tried searching using terms that will likely to yield some research studies in order to get information? For instance, I just googled "lap band revision study options" and got the info below. It's always good to include "study" in your search if you want to get information from a study as opposed to individual surgeons who may a personal bias towards one type b/c that's the type they do or financial stake in the matter. Try googling a bunch of different key words in different combinations. In case you don't know - the results of your search will always be listed in accordance with the words you entered in a search. For example, in the example of what I searched for above in google, "lap band" was given more of a priority for needing to be in the result list than "revision" was. If I had put revision before lap band, revision would be given more of a priority. You'll have a problem with only being able to view abstracts a lot of the time, but generally, that will serve your purpose. I think that the most important criterion in selecting a surgeon based on everything I've read is to find one who has a good amount of experience with revisions from lap band. Most surgeons are trained in various bariatric surgeries, but revisions are more challenging, so getting one who's already gone through the trial & error/ learning process is your best option. Good luck!!!!!!!!
Laproscopic revision from LAP-BAND to gastric bypass
Abstract:
While the majority of patients achieve good outcomes with the LAP-BAND
®, there is a subset of patients who experience complications or fail to lose sufficient weight after the banding procedure. This study examines the feasibility and outcome of performing laparoscopic Roux-en-Y gastric bypass (RYGBP) as a single-step revision surgery after a failed LAP-BAND procedure.
In the past five years we have performed more than 1400 LAP-BAND procedures. We laparoscopically converted 33 (30 females) of these patients (mean age = 43.8 years) from LAP-BAND to RYGBP because of inadequate weight loss and/or complications. Key steps in the revision procedures were (1) identification and release of the band capsule; (2) careful dissection of the gastrogastric sutures; (3) creation of a small gastric pouch; and (4) Roux-en-Y anterior colic anterior gastric pouch-jejunum anastomosis. Revisions took place at a mean 28.2 months (range = 11-46; SD = 11.3) after the original gastric banding. Change in body mass index (BMI) between pre- and postrevision was evaluated with paired
t tests.
Among the 33 patients who would undergo revision surgery, the mean BMI before the LAP-BAND procedure was 45.7 kg/m
2 (range = 39.9-53.0; SD = 3.4) and the mean weight was 126 kg (range = 99-155; SD = 17). The lowest BMI achieved by this group with the LAP-BAND before revision was 39.7 kg/m
2 (range = 30-49.2; SD = 4.9); however, the mean BMI at the time of revision was 42.8 kg/m
2 (range = 33.1-50; SD = 4.8). The mean revision operative time was 105 min (range = 85-175), and the mean hospital stay was 2.8 days (range = 1-10). Complications included one patient who underwent open reoperation and splenectomy for a bleeding spleen and one patient *****quired repair of an internal hernia. After conversion to RYGBP, mean BMI decreased to 33.9 kg/m
2 at 6 months (
p < 0.001) and 30.7 kg/m
2 (range = 22-39.6; SD = 5.3) at 12 months or more of followup (average = 15.7 months;
p < 0.0001).
Laparoscopic conversion from LAP-BAND to RYGBP is safe and can be an alternative for patients who failed the LAP-BAND procedure. However, revision surgery is technically challenging and should be performed only by surgeons who have completed the learning curve for laparoscopic RYGBP.