Lap Band Surgery Failure - 2 Types & How to Avoid Them
Reviewed by:Dr. Vafa Shayani
The LAP-BAND® failure rate (patients requiring removal of the band) is about 9% (fewer than 1 out of 10) for patients who maintain continued interaction with their surgical team and follow established guidelines closely (1). Failure:
- Is the result of inadequate weight loss and potential complications
- May or may not require removal of the band
- Can be avoided for most patients with proper diet and behavior
- Can often be fixed
Read and click the sections below for everything you need to know about LAP-BAND® failure symptoms, types, prevention, and options.
LAP-BAND® surgery failure comes in two forms. Click the section below that applies to you.
“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 studies directly reported on the percentage of failures, which were as low as 8% and as high as 68% of patients. An important distinction to make is that the most recent study, which shows a failure rate of 8%, is 1) the most recent and 2) based on a population of patients that maintained continued interaction with their surgical team and followed established guidelines closely. The earlier studies showing higher failure rates either were done when the LAP-BAND® was owned by a different company or when the practice did not always enforce proper patient behavior.
% of patients with unsuccessful weight loss after a specified amount of time
At 5 years: Under 9%
After 14 years – 68%
After 3.6 years – 62.5%
After 18 months -13.2%
3 Years – 23.8%
5 Years – 31.5%
7 Years – 36.9%
After 3 Years – 19%
With proper patient follow up care and behavior, the most recent study below (under 9% overall removal rate) most accurately reflects what new patients should expect.
# of LAP-BAND® surgery patients
% of patients with band removal due to a complication
At 5 years: Under 9%
Year of Study
- 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.Short arrows show pouch dilatation;
Large arrows show small amounts of
contrast material passing through
gastric band (3)
- 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.
Choosing the right weight loss surgeon is the first line of defense.
In general, the more experience your doctor has, the lower your risks. For example, one study found that the risk of adverse outcomes decreases by 10% for every 10 cases per year that a surgeon performs (4).
Your surgeon’s technique also makes a difference. Bariatric doctors performing the pars flaccida technique (PFT) when placing the band see up to 22% fewer LAP-BAND® reoperations than doctors using the perigastric technique (PGT) (5).
Take the time to learn how to find, interview and choose the best bariatric doctors.
The rest is up to you.
Following your doctors’ orders to the letter is much easier said than done, but it will greatly increase your chances for success. Specific factors under your control that have been proven to reduce LAP-BAND® surgery failure are your…
- Bariatric treatment research before surgery to set appropriate expectations
- Ability to follow your bariatric diet before and after surgery
- Adherence to an appropriate LAP-BAND® weight loss exercise program
- Participation in good in-person weight loss surgery support groups or online weight loss support groups
Click the above links to learn more about why each is important and what they entail.
Even if you find the perfect surgeon and do everything that you are supposed to before and after surgery, there is still a chance of LAP-BAND® failure. If it happens to you, you have a couple of options to stay on the path to a healthier body and weight…
Replacing the band
Conversion to a different procedure
For instance, one study showed that patents who underwent Roux-en-Y gastric bypass surgery after a failed LAP-BAND® had significantly more weight loss and exhibited better cholesterol levels than patients who underwent a rebanding operation.
In addition, 45% of the patients who had their band replaced needed yet another operation to fix a subsequent problem, while only 20% of the gastric bypass patients required a reoperation (6).
The most common conversion procedures include Roux-en-Y gastric bypass surgery, duodenal switch surgery and gastric sleeve surgery.
See our LAP-BAND® Revision Surgery page for your complete list of revision options.
Your Surgeon, OR Time for Someone New?
If you were happy with your first experience and are confident about your surgeon’s expertise and qualifications, stick with them.
However, if you’re unsure, get a second opinion. Initial one-one-one consultations with a new surgeon are usually free. Best case, you’ll find a better surgeon with better outcomes. Worst case, you’ll feel better about your decision to stick with the same surgeon.
04Find a Top Weight Loss Surgeon
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- Schedule a phone or in-person consultation
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References for Lap Band Surgery Failure
- Topart P, Becouarn G, Ritz P. Biliopancreatic diversion with duodenal switch or gastric bypass for failed gastric banding: retrospective study from two institutions with preliminary results. Surg Obes Relat Dis. 2007 Sep-Oct;3(5):521-5.
- Suter M, Calmes JM, Paroz A, Giusti V (2006) A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg 16:829–835
- For lap band complications references and more information, see Lap Band Problems & Lap Band Complications
- Relationship between surgeon volume and adverse outcomes after RYGB in Longitudinal Assessment of Bariatric Surgery (LABS) study. Mark D. Smith, Emma Patterson, Abdus S. Wahed, Steven H. Belle, Marc Bessler, Anita P. Courcoulas, David Flum, Valerie Halpin, James E. Mitchell, Alfons Pomp, Walter J. Pories, Bruce Wolfe
Surgery for Obesity and Related Diseases – 28 September 2009 (10.1016/j.soard.2009.09.009)
- Bueter M, Maroske J, Thalheimer A, et al. Short- and long-term results of laparoscopic gastric banding for morbid obesity. Langenbecks Arch Surg. 2008;393:199–205.
- Muller MK, Attigah N, Wildi S, et al. High secondary failure rate of rebanding after failed gastric banding. Surg Endosc. 2008;22:448–53.
- Pieroni, S, et. al. The “O” Sign, a Simple and Helpful Tool in the Diagnosis of Laparoscopic Adjustable Gastric Band Slippage. doi: 10.2214/AJR.09.3933 AJR July 2010 vol. 195 no. 1 137-141