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Despite the best of intentions, techniques, and precautions taken, it is true that the gastric lap band surgery does fail sometime. This article will look into the reasons for lap band failure and how this can be corrected through lap band revision surgery abroad in countries like Mexico, Costa Rica, India, and Belgium.

Why does the lap band fail?

The lap band could fail either all of a sudden leading to an emergency case or its effectiveness may lessen over time leading to chronic conditions. The patient’s commitment to healthy eating and regular exercise plays a very big role in determining whether the lap band fails or succeeds.

Depending on the reason for the failure of the lap band, the revision surgery procedure is determined.

Morbidly obese patients are better off with procedures like gastric bypass or duodenal switch than the lap band, as they might have much greater weight loss expectations.

Lap Band erosion: The lap band erodes into the stomach and causes the stomach to leak. This leads to a failed lap band ineffective and the patient may not lose any more weight. The most telling symptom of lap band erosion is infection near the port and the patient may even vomit blood. An endoscopy may be required to diagnose lap band erosion. There are two types of erosion: early and late. Early erosion may happen within 1-6 months of the surgery, whereas late erosion may happen much later and may go unnoticed. Alcohol and smoking are known to increase the risk of lap band erosion. Lap band erosions happen in about 14% of patients. (Source: Laparoscopic Bariatric Surgery by William B. Inabnet, Eric J. DeMaria, Sayeed Ikramuddin)

Slipped lap band: There are two types of slippage: anterior and posterior, that is, the lap band may slip on the front or back side of the stomach. Posterior slips have been reduced largely with changes in operation techniques.

Symptoms of lap band slippage are nausea and vomiting. Slips may happen if there aren’t enough stitches to hold the band in place or if the band has not been placed right. Another cause of lap band slippage is excessive eating and consequent vomiting.

Ineffective band/Failure to lose weight: In some patients, the gastric lap band may not produce any significant weight loss. This may indicate that the patient is not suited for restrictive weight loss surgery procedures. But, it is important to note that excess weight loss with the laparoscopic adjustable gastric band is lower than that with the gastric bypass or malabsorptive procedures, varying between 28% and 65% at 2 years and 54% at 5 years.

Lap Band Revision Surgery - Procedure Overview

Treatment options for lap band failure are either removing the band with no other weight loss method in place or removing the band and converting the patient to other obesity surgeries like Vertical Sleeve Gastrectomy, gastric bypass, the Duodenal Switch, or Ileal Transposition, depending on the patient’s physiology and behavioural aspects. (A study showed that laparoscopic conversion from lap band to Roux-en-Y gastric bypass is safe and can be an alternative for patients who failed the lap band.)

The conversion to other weight loss surgeries can be done the same time when the lap band is removed.

If the band has slipped, then the sutures have to be removed and the stomach positioned right again. In some cases, the band is placed through a new tunnel, but mostly, things are straightened out and the band placed back.

Things a de-banded patient must consider before choosing a new procedure

• What was the cause of the lap band failure: device failure or the patient’s lack of commitment to dietary restrictions, or was it both?
• Was the surgery method (restrictive surgery) the reason of the failure?

Lap Band Revision Surgery Risks/Complications

Lap band revision surgery is fairly less complicated compared to the revision surgeries for other weight loss procedures. Yet, it is always good to look for a bariatric surgeon who has a proven track record in lap band revision surgery.

The most unpleasant risk or danger of lap band revision surgery (in cases where the lap band is not removed but just re-positioned) is that it may fail again. In such a case, the patient may feel very de-motivated and may not continue with any other obesity surgery. But there is always the option of converting to gastric bypass or duodenal switch. Irrespective of the patient’s choice, one thing becomes clear: for whatever reason, the lap band will not work for the patient.

Weight loss after lap band revision surgery is usually not as dramatic as before the gastric banding failure. This is mainly because the patient, for some reason, has more difficulty in losing weight.

How to Avoid Lap Band Failure

While there is nothing you can really do to avoid mechanical issues like slipped lap band, you should definitely change your eating habits and inculcate a more active lifestyle to avoid a failed lap band.

Even before deciding on lap band, consult your bariatric surgeon if this will be the right weight loss procedure for you. Of course, you have to be frank to your surgeon and tell him/her about your eating habits, so that he can help you choose the right surgery.

Also, understand the failure rate of lap band and understand your chances of success, and the cost of lap band revision surgery and what the procedure involves.

Revision Surgery for Lap Band in Mexico vs USA

Patients with complications after lap band surgery may become eligible for insurance cover for revision surgery. However, it is generally more difficult to get insurance in the US in cases of revision surgery for unsatisfactory weight loss.

The cost of lap band revision surgery abroad in Mexico, Costa Rica, India, and Belgium is way below the cost incurred in the US. This cost is inclusive of not only lap band removal price but also conversion to other bariatric surgery. However, it is difficult to say what exactly the cost will be as it differs from patient to patient.

Also, the bariatric surgeon will need to see the X-ray of the patient’s entire gastro-intestinal system before the patient is accepted. Because, revision surgery is always more complicated than first-time surgery. For this reasons, patients can safely assume that the cost of lap band revision surgery will be at least 10-40% higher than first-time surgery. But those going abroad for lap band need not worry about the cost, as they save a lot on the US price.

The cost savings come with quality that matches that of the US health system. Lap band revision experts in Mexico, Costa Rica, India, and Belgium are sometimes more experienced than their US counterparts, because of the sheer number of patients they have to handle. They are very well qualified and speak fluent English, posing no communication problems to the patients.

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