- HEALTH TRACKER
I am desparate. I have been surfing the web for days. I just found this site and thought maybe I could better answers from people not trying to sell me their services and people who could relate.
I had a lap band put in May 2004. I need a revision. I have had complications (vomiting, acid reflux, not being able to get anything down - even unfilled) and have been seeking answers but am getting completely conflicting opinions. My band has not slipped or eroded but they feel I probably have a lot of scar tissue and that a revision could be dangerous. I have been told the gastric sleeve is the safest and then told by another its the most dangerous after lap band. I have been told gastric bypass (RNY) is the safest and then been told it is the most dangerous after lap band(due to my upper stomach tissue possibly being compromised). I am a self-pay and I am just so sick about all of this.
When I got the lap band I really did a lot of research. Now I feel like a DUMMY.
My original surgeon does not do anything but lapband and is in Mexico.
Any suggestions of a surgeon who is straight up and specializes in revisions?
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.
Laproscopic revision from LAP-BAND to gastric bypass
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/m2 (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/m2 (range = 30-49.2; SD = 4.9); however, the mean BMI at the time of revision was 42.8 kg/m2 (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/m2 at 6 months (p < 0.001) and 30.7 kg/m2 (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.