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De-Banding the Lap Band Can be Complicated

Today I want to share some concepts that frequently are misunderstood by Doctors starting a bariatric program, and by Banded Patients. There are several reasons for De-Banding a Lap-Band patient. Today I would like to focus on EROSION. The incidence of Stomach Erosion ranges from 2 to 15% of the patients who underwent a Lap Band Procedure . The occurence of erosion depends on the Surgeons learning curve, and various patient actions such as the consumption of alcohol, spicy or hot food, frequent vomiting or the use of some medications like Aspirin.

The concept I want to strongly point out is that De-banding due to stomach erosion could be much more challenging and difficult than the initial LAP BAND procedure itself, and requires a lot more experience and skills to do it safely and properly without having complications like leaking, intra-abdominal abscesses or infection at different levels.

Doing the De-Banding properly also means that the Surgeon has to keep in mind that the patient may require a Revision Surgery after six months, for a Re-banding, a Gastric sleeve or a Gastric Bypass Procedure.

In cases of infection or leaking during the De-Banding, the revision surgery will be very difficult, and prone to more frequent complication rates (5 to 30%), or may almost be impossible to be done because of heavy adhesions at the operatory site. As a matter of fact, the so called “learning curve” among Doctors when doing a De-Banding procedure requires a larger number of “supervised surgeries” than with the initial lap band, and the supervisions are usually done by an experienced Surgeon teaching the new bariatric surgeons or the General Surgeons under these conditions, to provide an opportunity for those patients to receive a new bariatric procedure.

If you require De-banding, be sure to inform yourself and look into finding the most experienced and qualified surgeon. Your health is important.

Dr. Arturo Rodriguez
Bariatric Surgeon

     

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