Lap Band Revision Surgery: Your 4 Options - Bariatric Surgery Source

Lap Band Revision Surgery: Your 4 Options

Reviewed by:  

John Rabkin, MD

Last Updated:  

10/10/2017

Lap band revision surgery:

  • Is necessary for unsuccesful weight loss or complications that require removal of the band.
  • Is usually performed as a single 2-stage procedure: band removal + new procedure
  • Includes 4 options: rebanding, convert to gastric sleeve, convert to gastric bypass, or convert to duodenal switch
  • Is covered by insurance if your policy includes bariatric surgery
  • Costs between $20,000 and $29,000 without insurance, before discounts and tax savings

Read and click the sections below for everything you need to know about gastric band revision surgery.

01When to Consider a Revision
  • Unsuccessful weight loss
  • Complication that requires removal of the band

Lap band surgery failure comes in two forms:

Unsuccessful weight loss

“Unsuccessful” means different things to different surgeons, but in general a procedure is considered to be a failure if you lose 25% to 30% or less of your excess weight (in other words, if you’re 100 pounds overweight that would mean you lost 25 to 30 pounds or less). Complete success generally means 50% or more of excess weight lost.

The following 3 studies directly reported on the percentage of failures, which were as low as 14% and as high as 68% of patients…

Studies
# of lap band patients in study
Studies
% of patients with unsuccessful weight loss after a specified amount of time
After 14 years – 68%
After 3.6 years – 62.5%
28.8%
After 18 months -13.2%
3 Years – 23.8%
5 Years – 31.5%
7 Years – 36.9%
After 3 Years – 19%
Studies
Year of Study

Complications that require removal of the band

Anywhere from 5% to 10% of patients have their band completely removed due to complications as the following three studies demonstrated…

Studies
Studies
Study A
Study A
Study B
Study B
Study C
Study C
Studies
# of lap band surgery patients
Study A
172
Study B
591
Study C
1,180
Studies
% of patients with band removal due to a complication
Study A
9.3%
Study B
8.6%
Study C
5.6%
Studies
Year of Study
Study A
2008
Study B
2008
Study C
2004

Problems that require lap band removal usually include one of the following complications, however, good bariatric doctors can often repair the problems without removing the band (3):

  • Band problems:
    • Band erosion (2.1% – 9.5% of patients) – (also called “band migration”) occurs when the band actually grows into the stomach. The only treatment is permanent removal of the band. See our Lap Band Erosion page for more information.
    • Band infection – (1.5% – 5.3% of patients) – if this occurs, it is usually healed with antibiotics, but removal of the band may be necessary.
    • Band intolerance symptoms include excessive vomiting or a continuous feeling of discomfort.  If these symptoms do not subside, removal of the band is the only option.
    • Band slippage (2% – 18% of patients) – occurs when the lower part of the stomach “slips” through the band, creating a bigger pouch above the band. Either removing fluid (from the lap band) or surgical repositioning it is required to repair it, although band removal may be necessary.

      Symptoms include vomiting and reflux, and it’s diagnosed by drinking a dye and checking for leaks via X-Ray. The band placement technique used by the surgeon also makes a difference; between the perigastric technique (PGT) and the pars flaccida technique (PFT), the pars flaccida technique appears to have a much lower rate of slippage (up to 16% less often).

      See this study for additional images of band slippage and more information about proper diagnosis.

      band slippage
      Short arrows show pouch dilatation;
      Large arrows show small amounts of
      contrast material passing through
      gastric band
      (4)
  • Difficulty swallowing (also called “dysphagia”) is caused by eating too quickly, too much or not chewing food enough. 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 – as a result of the patient’s gastric band, the esophagus cannot move food from the mouth to the stomach as well as it should. Symptoms may include difficulty swallowing, regurgitation of food and/or pain.
  • Gastro-esophageal reflux disease (GERD) is a highly variable chronic condition that is characterized by periodic episodes of gastro-esophageal reflux usually accompanied by heartburn and that may result in histopathologic changes in the esophagus. It also often leads to esophagitis. GERD increases the risk of some bariatric surgery complications such as sepsis, but the condition is also improved for many patients following bariatric surgery.

    Several at-home treatments are effective, including avoiding certain foods and drinks (alcohol, citrus juice, tomato-based food and chocolate), waiting 3 hours before lying down after a meal, eating smaller meals and elevating your head 8 inches when you lay down. If these don’t work, your doctor may recommend/prescribe antacids to be taken after meals and before going to bed, H2 blockers or even Proton Pump Inhibitors (PPI). If the condition becomes too severe, it may require removal of the band.
  • Port infection (1.5% – 5.3% of patients) – can occur in your abdomen at the port site. It is usually healed with antibiotics, but removal of the band or port may be necessary.
  • Pouch dilation (4.4% of patients) – refers to the enlarging of the pouch created after lap band surgery. It can often be fixed by removing fluid from the band but sometimes requires reoperation.

02One- Vs. Two-Stage Revision
  • Band removal and new procedure done at the same time or not
  • One-stage is most common

Any lap band revision procedure may be performed as a single-stage (band removed and new weight loss surgery technique performed during same procedure) or two-stage procedure (band removed during first procedure, sleeve performed during later procedure performed after healing).

Which method is best for you will depend on your situation, but most surgeons recommend a single-stage procedure.

However, if your band is being removed due to certain complications, it may be best to let your body heal before converting to another surgery.   In this less common case, two procedures may be more appropriate.

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034 Revision Procedures
  • Rebanding
  • Convert to Gastric Sleeve
  • Convert to Roux-en-Y Gastric Bypass
  • Convert to Duodenal Switch (DS)

Following are your 4 lap band revision surgery options along with corresponding research results.

Note that studies evaluating  lap band conversion to some procedures are extremely limited; we will continue to stay on top of new research and post updates as they are published.

Click the procedures below to expand more information about each.

Click here to contact a surgeon to discuss which procedure is best for your situation.

04Insurance
  • Lap-Band revision surgery is covered if your policy includes bariatric surgery
  • Click here to use our Check My Insurance Tool

If you have insurance that covers bariatric surgery, your plan will likely pay for both the removal of your band and the revision to another procedure. Of course, any applicable deductibles, copays and coinsurance will apply.

Use the tool below to find out if your plan includes weight loss surgery.

CHECK MY
INSURANCE TOOL
1

Choose your plan, state, and insurance company below.

Can’t find your insurance company/plan or have updated info? Click here to contact us.

This tool provides estimates only. Please contact your insurance company to verify your actual out of pocket costs.

05Cost Without Insurance
  • Total Cost: $20,000 – $29,000
  • Loan Payment: ~$550/month
  • Discounts & Tax Savings: Usually available

If performed as a single-stage procedure, total fees for the surgeon’s portion of the work are likely to be about 30% higher than they would be if your new surgery was performed as a primary procedure (instead of a revision).

If performed as a two-stage procedure, there would be two separate hospital and anesthesia charges (no discount) and two separate sets of professional fees (the surgeon would likely discount their fees).

Based on our most recent Annual Bariatric Surgeon Cost Survey, the total average costs of a single-stage Lap-Band removal plus conversion procedure in the U.S. are as follows (assumes surgeon/professional fees are 20% of total cost):

  • Lap Band Conversion to Gastric Sleeve: About $20,100 (U.S. Average)
  • Lap Band Conversion to Gastric Bypass: About $25,500 (U.S. Average)
  • Lap Band Conversion to Duodenal Switch: About $28,600 (U.S. Average)

Hospital & Anesthesia Cost Details

While many bariatric surgeons work closely with hospitals to develop a packaged fee, hospital charges are ultimately independent of the surgeon’s charges.

The hospital and anesthesia portions of the cost will vary from hospital to hospital. For example:

  • Some hospitals offer a set fee regardless of procedure performed
  • Some may add an extra amount for the more involved revision procedure (as compared to a primary bariatric procedure)
  • Some may charge on a “fee for service” basis (pay depending on operating time and materials used)

While many bariatric surgeons work closely with hospitals to develop a packaged fee, hospital charges are ultimately independent of the surgeon’s charges.

Region-Specific Lap-Band Revision Surgery Cost Estimates

For region-specific estimates for each separate lap band conversion procedure, use the interactive map below to find the average cost of the chosen conversion procedure in your area (gastric sleeve, gastric bypass or duodenal switch) and use the following equation:

Estimated Average Lap Band Revision Cost for Your Area
=
(Average Cost of New Procedure in Your Area (use tool below) X 0.2 X 1.3)
+
(Average Cost of New Procedure in Your Area (use tool below) X 0.8)

Or click your state in the map below...

  • Lowest Cost

  • Mid Range

  • Highest Cost

  • No Data

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Or click your state in the map below...

  • Lowest Cost

  • Mid Range

  • Highest Cost

  • No Data

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Or click your state in the map below...

  • Lowest Cost

  • Mid Range

  • Highest Cost

  • No Data

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Or click your state in the map below...

  • Lowest Cost

  • Mid Range

  • Highest Cost

  • No Data

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Cost Survey Results for MEXICO*


Including Cancun, Guadalajara, Los Cabos, Mexicali, Monterrey, Puerto Vallarta and Tijuana

<-- swipe to see other years -->
 201520162017
Gastric Bypass$7,772$7,422n/a
Gastric Banding (Lap Band)$6,101$5,826n/a
Gastric Sleeve$5,367$5,125n/a
Duodenal Switch$8,440$8,060n/a

* 10 Practices in Mexico were contacted to calculate these averages.

Exact Quote for You

Click here to find a top surgeon near you. Their office will be able to provide you with a more exact quote.

Discounts: 6 Discounts to Ask Your Surgeon About

Talk with your surgeon about whether any of these discounts are available:

  1. Self-Pay Discounts. Most surgeons offer self-pay discounts or payment plans. Just ask!
  2. Other Discounts. Some offer discounts if you pay the total amount in advance.
  3. Same Surgeon, Different Hospitals. Some surgeons operate at more than one hospital. Hospital costs make up the biggest part of the bill, so find out if your surgeon has a choice.
  4. Pre-Op Costs. Some surgeons include pre-op costs in their quoted fees. Pre-op costs include things like testing and office visits.
  5. Complications. Should they arise, may increase total costs. Ask your surgeon who will pay if a complication arises during surgery. Some surgeons will include the cost of any complications in their quote while others will charge extra.
  6. Health Insurance That Does Not Include Bariatric Surgery. You may still get insurance to pay for some costs that could be applied to covered treatments. For example, lab work is needed for many reasons outside of bariatric surgery. Your surgeon can help you find those advantages in your plan.

Financing: 7 Ways to Make Surgery More Affordable

Lap-Band revision surgery financing is available almost everywhere. It helps pay for:

  • The entire cost of surgery
  • The part that insurance doesn’t cover, like deductibles, copays, or coinsurance

Financing options to make gastric sleeve surgery more affordable include:

  1. Payment Plan Through a Qualified Surgeon
  2. Brokers, Direct Lenders, and Credit Cards (Unsecured Medical Loans)
  3. Friends & Family
  4. Secured Medical Loans
  5. Retirement Plan Loans
  6. Permanent Life Insurance Loans
  7. Medical travel – having surgery in a location that is less expensive than where you live

Click here for more information about each option.

Tax Savings: Tax Deductions & Special Tax-Favored Accounts

Click your country below to find out if tax savings are available:

United States: Might Be Deductible, Special Tax-Favored Accounts Available

Lap-Band surgery is tax deductible, which can have a big impact on the total cost of surgery.

You can deduct medical expenses if the costs are more than 10% of your adjusted gross income.

To receive the deductions, you’ll need to complete Schedule A of the IRS Form 1040. You’ll also need to save your medical bills and payment statements as proof.

Money in special savings accounts (or even your IRA) may also be a way to pay for part of surgery tax-free:

  1. Health Savings Account (HSA) – You can open an HSA alongside a “qualified high deductible” health plan. Tax-free HSA money can be used to pay for qualified medical expenses. No other account receives better tax treatment. You can even transfer IRA money into an HSA. See the IRS’s Site for more info.
  2. Archer Medical Savings Account (Archer MSA) – Archer MSAs are like HSAs for the self-employed or small businesses. Click here for details.
  3. Health Reimbursement Account (HRA) – HRAs are only offered by employers who set them up and contribute money to them. If your company offers one, make sure your plan allows the use of HRA funds to pay for “all qualified medical expenses.” Click here for more info.
  4. Flexible Spending Account (FSA) – Both employers and employees can contribute to an FSA, also known by its IRS code, “Section 125”. Money from them can be taken out tax-free if it is used for qualified medical expenses. Click here to get the summary from the IRS.

Canada: Is Deductible

Canada is generous compared to other countries when it comes to medical tax deductions. If you have a prescription, receipt, or other documentation, you can write off your Lap-Band surgery expenses.

If surgery is covered by your insurance, you can also deduct your:

  • Out-of-pocket expenses
  • Monthly insurance premium

If your income is below a certain amount, you may qualify for a tax credit called the refundable medical expense supplement.

Australia: Might Be Deductible

In Australia, you can write off your Lap-Band surgery expenses if the costs are over the Australian Taxation Office (ATO) threshold.

According to the ATO:

“To claim the net medical expenses tax offset in your tax return, you will need to know the total medical expenses you incurred for yourself and your dependants. You then deduct any refunds from Medicare, your health fund or any other reimbursements that relate to those expenses received during the financial year.”

Click here for updated Medicare Benefit Tax Statement information from the Department of Human Services.

06Help & Support
  • Ask the expert
  • Patient experiences

We would love to hear your experiences with Lap-band revisions. Your insights are invaluable to making sure other people have the tools to meet their goals.

We would also be happy to answer any questions you may have about Lap-band revisions.

Please use the form below to share your experience or ask a question.

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07Find a Top Lap-Band Revision Surgeon
  • Ask for a free insurance check or cost quote
  • Attend a free seminar or webinar
  • Schedule a phone or in-person consultation (both often free)

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* Disclaimer: The information contained in this website is provided for general information purposes and your specific results may vary depending on a variety of circumstances. It is not intended as nor should be relied upon as medical advice. Rather, it is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician(s). Before you use any of the information provided in the site, you should seek the advice of a qualified medical, dietary, fitness or other appropriate professional. Read More