Risks of Gastric Sleeve After Failed Lap Band

Question Below Submitted By:  

Natasha H. (a patient from Longueuil, Quebec, Canada)

Complication began February 2015, I was experiencing a feeling of being stuck and neither food nor saliva would stay down, it was believed by myself that a slow release antibiotic tablet being taken for a kidney infection was the cause.

Five days after this started I went to emergency to discover that the injection portal was flipped upside down and they could not turn it around without surgery. Once that was done I thought it was all okay. After 5 days the staples were removed and 5 days after that the wound was leaking, I was back and forth to emergency, at which point the tube from port to band was peeking out of the wound which had completely opened. Now it had to be removed.

I was told that I could no longer have a band and that the next recommended option is the gastric sleeve.

My concern is that as I have had the band the surgeon claims that the internal scarring puts me at about 2x the risk for complications.

I have already gained back 50lbs from the 100 I had lost and I am physically ailing no matter what I do.

I have 2 young children and I am worried that this surgery may cause either severe complication or death.

What is the actual percentage of risk (I have read that there may be a 5-12% chance of severe complications), and have there been many documented cases that have gone severely wrong? Because of my children this is a very hard decision and even my surgeon has told me to take more time to think about it.

Would appreciate your insight, making the decision for the band was much easier than this one, and I find there is little reassurance that things would go well versus not.

Thank you.

Natasha

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01.

Expert Responses to the Question Above

Surgeon response to "Risks of Gastric Sleeve After Failed Lap Band"

by: John Rabkin, MD

Natasha,

You are correct in the analysis of your research that revisional bariatric surgery carries with it a higher risk of complications than primary bariatric surgery.

However, although "2X the risk" seems ominous, the overall risk is still quite low and acceptable keeping in mind the benefits that will accrue to your health from the weight loss that you will enjoy after undergoing the revisional procedure.

One recent study in the journal Surgery for Obesity and Related Disease (2013 Nov-Dec; 9(6) 901-7) looked at thirteen failed adjustable gastric bands (AGB) converted to vertical sleeve gastrectomies (VSG, also called gastric sleeve surgery) and found that only one patient experienced a complication necessitating re-hospitalization: severe reflux (heartburn/indigestion) requiring an anti-reflux procedure to subsequently be performed.

All thirteen patients enjoyed excellent weight loss and an improvement in their health.

My recommendation is that you should pursue this option in the hands of an experienced bariatric surgeon who has performed these revisional bariatric procedures on other patients before you.

As these revisions from failed AGBs are routinely more technically challenging than primary VSGs, you don't want to be your bariatric surgeon's first revisional case!

John Rabkin,
M.D. Pacific Laparoscopy

(click here for Dr. Rabkin's full bio & contact info)

DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

Related Pages:
- Complications & Risks of Gastric Sleeve Surgery
- Lap Band Surgery Failure - 2 Types & How to Avoid Them
- Lap Band Removal: Complete Patient Guide
- Lap Band Revision Surgery Options

02.

Patient Responses to the Question Above

Failed band - again!

by: Yiota

I am in the process of making a really difficult decision and some advice from a professional would be greatly appreciated. I originally had my gastric band fitted in August 2009 - over the next three years I lost 100 lbs.

Then the tube to my band developed a leak due to rubbing on my rib. A second surgery was performed by the same surgeon to repair the band in March of 2012. Things were great again and I soon lost the weight I'd regained and managed to stay stable until recently. I've been steadily gaining weight and after seeing the Dr have discovered that my band has failed again.

My Dr wants to repair/replace my band with a third surgery! I'm really upset to be in this position again. I've lost all confidence and faith in the band.

I'm unsure of what is best to do? Should I consider another surgery? Would a gastric sleeve be a better option?

Please help.....Yiota

Revision from Band to Gastric Sleeve

by: Anonymous

Natasha -

The key here is to go to a surgeon with experience in dealing with the scar tissue that the band has caused. It is a couple of hours to remove the band and the scar tissue. Then the gastric sleeve procedure adds another couple hours.

You will have far better results in weight loss from the gastric sleeve than the lap band. I had a lap band revision surgery and went to a gastric sleeve AND duodenal switch. I was in surgery for 10-1/2 hours, but the results were well worth it. My surgeon was highly experienced in revision surgeries though.

Getting the band out was the best thing I did. I am very happy I did the revision surgery a year ago. Healing is quick too.

Good luck!!

Fail band then I had a sleeve

by: Sharon Ayles

I too after 5 years of my band being a success and losing over 140lb had complications when I got a stomach sinus. It was removed but did not heal and the band peaked out and had to be removed. While it was being removed, it was noticed that several abscesses caused by an infected port were there.

After removal in January, I gained 28 lb then decided to have the sleeve. All went well, however, initially, I lost 14 lbs, but have since put back on the weight. The sleeve is not a success for me, I have an appetite the same as before I had the sleeve. I am so glad I had the band first. I feel like I wasted £7000.00. I am having to really focus on a controlled diet to stay the same weight. The sleeve was a waste of time and money and the band was so successful.

The sleeve is not worth the risk to your health.

Fail band

by: Kel

I had the band put in in 2010. I lost significant amount of weight but after having two babies back to back, the weight came back.

I have had numerous of stomach issues and not being able to swallow meat or any kind of food and liquid I was wondering will my insurance pay for the gastric sleeve?

Gastric Sleeve

by: Flower

I guess for one why do doctor's still perform the lap band when there are so many failures? I had mine done in 2010 and the most I have lost is 45 lbs. In September I had gallbladder surgery and the stone went into my pancreas causing jaundice and after a 5 hour surgery I almost died.

I have had two c-sections. If I do get lap band reversal when the scare tissue is removed will the doctor also get the scar tissue from my lap band? What are the chances of bleeding. My doctor suggested that I do that part first and then go in later for the gastric sleeve.

I don't want to die but I still way 300 lbs so either way I might die due to my weight or the operations. Is it true that Medicare now pays for this procedure? I am 66 years old and I too old for this?

LAP BAND REMOVED WANT GASTRIC SLEEVE

by: Jeanne

I had the band put in in 2013 and had to have emergency surgery in May 2016 to remove the band due to me going down to 85.6 pounds. Yes, that is right 85.6. I initially weighed 240 when I had the band put in but started to realize in 2015 that I was vomiting a lot more.

I went to my doctor who sent me for an upper G.I. series and it was determined that my band had slipped a little. My doctor said there was nothing to worry about and removed the fluid from the band.

I asked if he could correct it and he said no, no worries. Well I have fine for about the first 6 months then the vomiting started again. I could only eat soup. Then I became very tired all the time and noticed my size was withering away. I went back to my doctor with my daughter who insisted that I have the band removed immediately. He wanted to put me on the schedule and I would have to wait two weeks.

I said no I want it out immediately. He told me to go to the ER then. When I got to the ER and they started working me up, my potassium level was at a 1.5 and it should have been at a 8 or 9. Everyone was shocked that I was still walking and talking. I told them I want the band out and I had the surgery the next morning by my doctor. I was never billed for the surgery by him and never saw him again. I am, right now, going through the process of having the sleeve done instead of the bypass.

I heard so many different things that if I get the sleeve I won't lose more than 30% of my weight now, and then heard other things. I really don't want to do the bypass due to the side effects. Is the sleeve going to be effective?

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