The LAP-BAND®: 10 Years Later

I am very worried about losing my band or going through all this only to have it slip again.

M

In a recent study from France "Food Intolerance After Adjustable Gastric Banding: A Major Cause of Long-Term Band Removal" erosion, slippage, and esophageal dilatation are widely acknowledged as typical long-term complications of lap banding. Jérôme Dargent  reported that food intolerance has become a leading cause for band removal. 

In a recent study by Tucker et al (Tucker O, Sucandy I, Szomstein S, Rosenthal RJ. Abstract Revisional surgery after failed laparoscopic adjustable gastric banding. Surg Obes Relat Dis. 2008 Jun 6. [Epub ahead of print] PMID: 18539539) report on "a retrospective review of a prospectively maintained database of primary LAGB and revisional surgery after failed LAGB."

They reported that the mean follow-up was only about 3 1/2 years. The early surgical reoperation rate was 6%. Band removal 39%, band removal and sleeve gastrectomy in 15%, band removal and conversion to Roux-en-Y gastric bypass in 7%, band repositioning in 10%, device-related reoperation in 9%, conversion to another bariatric procedure in 4%, and other procedures in 16%.

Rise and Fall of Lap Gastric Band
1993 - Enthusiasm for the LAP-BAND® in Europe
Simple, Safe, Somewhat effective
10 years Later: Attraction Fading in Europe
Rising Complication Rates
Declining Weight Loss
Surgeons “Voting with Their Feet”
1998 Ratio Band/RNY = 20/1
2004 Ratio Band/RNY = 1/4

I had the lap band procedure (3 years ago). With the lap band I dived into exercise after the surgery and managed to lose about 100 pounds. However after about 7 or 8 months I started to have pain in band area and reflux at night and during the day. This pain can happen when I have not eaten, after eating or in between eating. This led to adjustment after adjustment.

If I was to compare the MGB procedure with the lap band I would say the MGB was much easier on me.

My surgery went well. I had quite a bit of pain in my left side. Dr R said this was because they have to pull the lap band out of a small hole. Also he said it was a bit embedded in my stomach. I was given the choice to stay an extra night (2 nights total) because I was having pain. The nurse staff seemed kind of understaffed in the hospital but they were nice. Some of them knew all about the MGB and some were quite ignorant about it. It was what I would call a typical hospital experience. I walked the halls a lot the second night until the next day I was ready to get the heck out of there. On the way back to the hotel we went to Blockbuster and got some movies and to a drug store for some supplies. Now when I look back on it I didn’t drink enough water and eat enough salt in the days following my surgery. This made me very shaky. It felt like I had low blood sugar. We went to the Stratosphere about 4 days after surgery. I broke out in cold sweats and had to sit down a lot. I called Dr R and he said it sounded like I needed salt. I got some salt packets and ate them. I did feel better. I had to start to force my self to eat chips, pretzels , salt and drink water and Gatorade for the next few days. When I went in for my last day at the clinic I had lost 24 pounds in 1 week. Dr R said this was probably at least ½ water weight from lack of salt. The entire plane ride home I drank and ate chips and pretzels and salt. By the day after I got home I was feeling much better. I was back to work the day after that (I have a desk job). By the next week I was feeling pretty much back to normal. Of course I had to manage through the adventure of the 3 stage diet. But as a lap bandster I had experience with this type of thing so it was not that big of a deal.

Since the surgery the main thing I notice is how wonderful it is to not have the band anymore. I can eat whatever I want. I just need to watch the portion on some foods. High sugar and high fat foods need to be eaten slowly and in small amounts. Most normal foods, fruits veggies and meats are fine. If I do eat to many fried foods or high sugar foods I get what they call “dumping syndrome”. I get very tired and a bit dizzy. I feel like I need to lay down, get bad gas and need to go to the bathroom. After some time I have recognized what foods are bad for me. Sometimes I still eat them and pay the price though. When I had the band they said, protein first, veggies second then the rest. Well, I could never do that with the band because it wouldn’t go down and I would be in pain and have to throw up (if I was lucky). With the MGB I can really eat meat, veggies and fruit.

The MGB is not without a few trade offs for me. I have bad smelling BM, frequent gas and frequent loose stools. This however has gotten better now that I am almost 10 months out. Currently my weight loss has stopped and I have lost about 80 pounds since the surgery. I am hopeful that it will start again at some point though.

I hope this helps.

In a recent study from the Department of Surgery in Basel, Switzerland the Band is not looking to good.  After follow up of about 5 years, of the 380 patients, 128 (33.7%) had their bands removed. 1/3 of Band Patients had their band removed by 5 years!  Yikes!! 

Even more bad news: The weight loss of the remaining 2/3's of patients (66.3%) with the band still in place was poor, only 1 in 4 (25%) lost even half of their excess weight. (Wölnerhanssen BK, Peters T, Kern B, Schötzau A, Ackermann C, von Flüe M, Peterli R. Predictors of outcome in treatment of morbid obesity by laparoscopic adjustable gastric banding: results of prospective study of 380 patients. Surg Obes Relat Dis. 2008 Jun 27)

I have failed!!
"I had my surgery on January 2006 and have not lost any weight!"

Like many of our patients: "I can't eat anything in the morning (I even have a hard time drinking hot tea) and at lunch it takes me about an hour and a half to eat a WW dinner."

Band patients often return to old remedy's when the band fails: "I have tried joining WW which is not working (that is why I had this surgery) and things are so depressing... I have had 3 fills one un-fill and 2 more fills."

It is a sad story: "I am self paid and will be paying on this unsuccessful surgery for 3 more years."

"Banded 1/6/2006 Had 3 fills (don't know the specifics)
After a year, only 20 lbs down.
Now on Weight Watchers and losing slowly."

"I got my band in 2006. First my port got infected and I had to have two surgeries ... to replace it. But I was still pro band. ... until that summer. ... I had lost close to 80 pounds... Then I started having problems with the band being too tight. And for every fill I had to get an unfill. Then, it happened.

My band slipped. I was in the car with children, I had to pull over and throw up very, very violently. ... I had horrible reflux and a terrible pain. I had my band unfilled, waited several weeks... Finally, I had surgery to have it corrected. I had a horrible experience in the hospital,

Unfortunately, it became pretty obvious that ... I wasn't losing any weight at all, and in fact was gaining pretty rapidly. I chalked it up to not having a proper fill. Apparently, that wasn't it. The band had slipped again. We went through the whole unfill and wait period, and once again, it was worse instead of better. I was really, really depressed. ... I found out that he didn't do the bypass laparoscopically anymore, so with my fear of hospitals, the idea of an extended stay ruled that one out. My insurance didn't cover the sleeve, and the almost $50,000 price tag ruled that one out. So, I've gotten rebanded ..."

I was banded in 2002 I have been doing well... just happy maintaining what weight loss I've had....  I gained 20lbs...

However, starting the end of several weeks ago my band just got real tight... I am having difficulties in the mornings getting any liquids down at all... seems it is less strictured late afternoons...I am feeling real tired...I know I am not ingesting enough calories...

L