Lap band removal is common… as many as half of all lap band patients eventually have their band taken out for a number of reasons ranging from inadequate weight loss to serious complications.
Fortunately, it is a relatively straightforward procedure, and there are several options for converting to another weight loss surgery to maintain and improve long-term weight loss and health problems.
This page will discuss the following (click links or scroll down page to review all topics)…
- When Removal of Your Gastric Band is Appropriate
- The Gastric Band Removal Procedure
- Cost, Insurance & Financing of Removal Procedure
- Weight Regain Risk After Your Band is Removed
- Lap Band Revision Surgery Options (Converting to Another Procedure)(on a separate page)
When Lap Band Removal Is Appropriate
There are several reasons that a lap band removal may be required, including…
- Lack of adequate weight loss (losing less than 25% to 30% of your excess weight) – occurs in up to 40% of gastric band (lap band) patients.
- Band erosion – occurs when the band actually grows into the stomach.
- Band infection – if any infection cannot be healed with antibiotics, lap band removal may be necessary.
- Band intolerance symptoms include excessive nausea/vomiting or a continuous feeling of discomfort/pain.
- Band slippage – occurs when the lower part of the stomach “slips” up through the band, creating a bigger pouch above the band. Either removing fluid from the band or surgical repositioning is required to repair it, although band removal may be necessary.
- Difficulty swallowing (also called “dysphagia”) esophageal dilais caused by eating too quickly, eating too much or not chewing food enough before swallowing. While it can usually be avoided by addressing these issues, some patients’ bodies simply can’t get over this problem, in which case band removal is required.
- Esophageal Dysmotility and/or Dilatation essentially means that, as a result of the patient’s gastric band, the esophagus is no longer able to effectively transport food from the mouth to the stomach. Symptoms may include difficulty swallowing, regurgitation of food and/or pain.
- Gastroesophageal reflux disease (GERD) is a chronic condition resulting in episodes of gastroesophageal reflux, heartburn and potential damage to the esophagus. It also often leads to esophagitis (inflammation of the esophagus that may damage the tissue). Many methods exist to address band-related GERD, but if they are ineffective then the band will need to be removed to treat the issue.
- Pouch dilation – refers to the enlarging of the stomach pouch that forms above the band. It can often be fixed by removing fluid from the band but sometimes requires reoperation.
- Port infection – can occur in your abdomen at the port site. Lap band removal will be required if the problem is chronic or not able to be healed by antibiotics.
The Gastric Band Removal Procedure
If your initial gastric band surgery was performed laparoscopically (using 5 or 6 small incisions in your abdomen), it will likely be possible for your removal procedure to be performed laparoscopically as well.
If this is the case, the gastric band removal procedure can be relatively quick and easy depending on existing complications; total surgery time should be one hour or less (the actual act of removing the band typically takes no more than 10 minutes in straightforward situations).
During the procedure, your surgeon will:
- Cut away the “capsule” that your body has formed around the band
- Remove the sutures that were created to hold the band in place and cut away any adhesions (scar tissue) that have formed
- Cut the band itself
- Pull out the band from around the stomach and remove it along with the tube
- Remove the port through the incision in which it was inserted originally (reopen the same incision)
Important: Talk with Your Surgeon About Step 2
After your lap band was put in place during your primary surgery, your surgeon pulled the top part of the stomach over the band and sutured it to the part of your stomach below the band in order to help the band stay in place.
When removing your band, your surgeon should also remove the sutures and any adhesions that have formed instead of only cutting and removing the band. This will fully bring your stomach back to its original state.
Many surgeons cut the band and pull it out from around your stomach without cutting the old sutures and adhesions that held the band in place (they skip Step 2), leaving the stomach folded over on itself.
While the stomach will function as it did before your gastric band surgery, without this additional step it will make any lap band revision surgery much more difficult to perform.
The removal procedure is likely to carry a similar risk of complications as the initial procedure (relatively low risk).
Cost, Financing & Insurance and Lap Band Removal
If your insurance company covers weight loss surgery, it will likely pay for the removal of your band and even a revision to another procedure (either at the same time or during a subsequent surgery).
Lap Band Removal Cost Components
- Initial consultation with surgeon
- Consultations with other providers (e.g., Pulmonologist, cardiologist, respiratory therapist, etc.)
- Pre-op lab work and other tests
- Clinic or hospital fees
- Surgeon’s fee (during surgery)
- Surgical Assistant’s fee (during surgery)
- Anesthesia
- Post-op testing (e.g. barium swallow, chest x-ray, etc.)
- Care following surgery, including surgeon consultations (usually necessary for up to 90 days)
If you do not have insurance that covers it, self-pay costs for lap band removal will be similar to the cost of the initial procedure: about $15,000 USD (lap band cost varies widely by state/region) depending on the nature of any complications.
However, given the increasing number of patients requiring lap band removal, some surgeons have developed a less expensive flat fee for self-pay patients, regardless of complications (not including the cost to convert to a different procedure).
Costs will be higher (but discounted overall) if you have a gastric band revision procedure done at the same time.
Weight Gain After Lap Band Removal & Lap Band Revision Options
For most patients, the stomach returns to is normal state following lap band removal. If your band helped you develop good diet and exercise habits and you are able to maintain them following its removal, you may be able to keep the weight off.
Unfortunately, the loss of your band’s stomach restriction usually leads to increased feelings of hunger. As a result, most lap band removal patients revert to their pre-surgery weight unless they decide to have a weight loss surgery revision procedure performed.
If you are on the fence and want to try to maintain your weight loss on your own, revision surgery can be performed as a two-step procedure: during procedure 1 your band is removed; during procedure 2 your revision is performed.
Keep in mind that a two-step procedure will likely be much more costly than a one-step procedure, especially if you don’t have bariatric surgery insurance.
If you were not able to lose weight with the band or are not confident that you will be able to keep the weight off, you may want to consider revision surgery