Lapband Pouch stretching - Revision Surgery

[br1ghteyes75]

Hi,

I'm wondering whether there is anyone out there in the same position as me, I had my band in Oct 2007 and have had huge success, I lost all of my weight within 16 months (8 stone) however 3 stone of that has been becuase I have had acid reflux and vomitting and have had a very soft food diet for a long time.

I had my band emptied completely in Aug and the symptoms almost disappeared although still had some indigestion and a fairly good level of restriction.

I then had 1.5cc put back into the band last week and was instantly sick again with indigestion, so was emptied again.

I've now had an x-ray and been told that my band is in a horizontal position which isn't normal and that my pouch is much larger than it should be.

Food is passing through the pouch but slowly and there is food residue remaining which is supposedly what is causing the indigestion.

I've been told that I may need to have revision surgery to replace the band in the correct position but obviously am worried that the same thing will happen again, I don't know whether if it comes to it to have the bypass, I've worked so hard to get into my size 10's I don't want to ever go back to being overweight so whilst the bypass may seem extreme, I'm not sure what other choice is available to me.

I would love to hear from anyone in similar circumstances and what they have been told. I am awaiting advice from my aftercare people and also my original surgeon.

Thank you

 

[j.u.s.t.l.i.z.]

i had my 1st band removed and replaced last year after 3.5 years but for different reasons to you, i also panicked and thought about the bypass route but they said no to that as it would be unhealthy bypassing some one thats now got a lower bmi, which now im glad that was said as i know the band is best for my eating habbits, i hope they sort this problem out for you soon.

good luck

liz x

 

[br1ghteyes75]

Thanks Liz, did you have it done on the NHS or pay again, I paid for my operation privately and would struggle to come up with the money again, I will if necessary but would like to think the NHS may help me now that I am no longer morbidly obese and have potentially saved the NHS thousands.

 

[I will get there one day!]

Hi and welcome!

My circumstances are similarish. I had a band in January of this year. I had problems from the start in so far as I had virtually no restriction even when my band was pretty much full and had mega heartburn/reflux. This left me feeling really despondent as I wasn't losing any weight. I had an xray and found out that the band was definitely in the correct position but just for some reason didn't work for me. Rather than continuing to mess around I had a bypass 2 weeks ago. I just felt and was advised that this would be a more predictable way forward. I'm obviously early days but so far so good. Unfortunately my PCT have very strict criteria and I therefore had to pay privately for both (will be paying off for the next few years!). I've viewed it as an investment. Fingers crossed!

All the best and let us know what you decide.

x

 

[Silversurfer]

In my opinion isn't it better to have done one op and got it right in the first place than have to undergo revision after revision, its my belief that these sorts of issues are fairly common with bands, so i'd be asking myself how long its going to be before it again fails or you have to have more revision.
The bypass may seem like a more extreme option, but once its done and there its for life, with very little after maintenance.
That said would you at your current weight reach the criteria for a bypass ? or if going private would you be able to convince a surgeon to actually do it ? it would almost be like a thin person with the correct BMI asking for a bypass because they might get fat !

 

[j.u.s.t.l.i.z.]

Thanks Liz, did you have it done on the NHS or pay again, I paid for my operation privately and would struggle to come up with the money again, I will if necessary but would like to think the NHS may help me now that I am no longer morbidly obese and have potentially saved the NHS thousands.

my 1st band was nhs so they replaced it no problems so i was lucky in that sense, you would have to see if your pct would fund this but some times the nhs wont do private patients, it is worth an ask though. what did your providor say about the matter ?

liz x

 

[thinkbethin]

I really hope they can sort it out for youxxx

 

[32bme]

That sound really awful, can relate to that re the fear of getting bigger even though you are slim now.
I have heard of this happening (the band slipping) i hope you find a solution via what ever means.

 

[br1ghteyes75]

I'm waiting to hear from my original surgeon as to what the best course of action is. At the moment my biggest fear is putting on weight again, I'm not naive enough to think that I don't need a band or anything anymore and all my weight issues are over just because I'm slim, every day is a constant battle but for once looking in the mirror makes it all worthwhile because I'm happy at what I see back.

Nicola - I hope you now how the success you're after and get the weight off, it really is the best feeling in the world walking into shops and knowing there is something in there for you!

Silversurfer - harsh but true, I doubt I would now be eligable for a bypass, it's a depressing thought to think I may just be left out in the wilderness so to speak until my bmi is back to unhealthy again. At the same time, if I just have the band replaced, what is to stop it happening again.

Having said all of that, I wouldn't change it for the world, being slim after years of being overweight counteracts all of the expense!

Thanks for comments

 

[Mazza]

In my opinion isn't it better to have done one op and got it right in the first place than have to undergo revision after revision, its my belief that these sorts of issues are fairly common with bands, so i'd be asking myself how long its going to be before it again fails or you have to have more revision.
The bypass may seem like a more extreme option, but once its done and there its for life, with very little after maintenance.
That said would you at your current weight reach the criteria for a bypass ? or if going private would you be able to convince a surgeon to actually do it ? it would almost be like a thin person with the correct BMI asking for a bypass because they might get fat !

I found the following interesting.

A recent study revealed that severely obese patients who chose bypass surgery, reduced their risk of premature death by up to 89 percent, compared to equally overweight patients who did not get surgical treatment.

Which is excellent, however:

About 10-20 percent of patients undergoing stomach bypass require follow-up operations to correct complications, the most common complaints being abdominal hernias.
More than one-third of patients who have gastric bypass surgery develop gallstones.
Complication rates in the early post-operative period, such as infection, dehiscence, leaks from staple breakdown, stomal stenosis, ulcers and deep thrombo-phlebitis may be as high as ten percent or more. However, the combined risk of the most serious complications (gastrointestinal leak and deep venous thrombosis) is less than one per cent.
Over the long term, the health complications of gastric bypass may include a variety of conditions and problems. According to one 14-year follow-up study of stomach bypass patients, the morbidity rates were as follows: vitamin B12 deficiency (39.9 percent), incisional hernia, (23.9 percent), depression (23.7 percent), staple line failure (15 percent), gastritis ( 13.2 percent), cholecystitis (11.4 percent), anastomotic problems (9.8 percent), dehydration malnutrition (5.8 percent), dilated pouch (3.2 percent).

Both procedures present a risk of follow up surgery whether its revision or otherwise.

I hope you get something sorted soon brighteyes.

 

[Silversurfer]

I'm waiting to hear from my original surgeon as to what the best course of action is. At the moment my biggest fear is putting on weight again, I'm not naive enough to think that I don't need a band or anything anymore and all my weight issues are over just because I'm slim, every day is a constant battle but for once looking in the mirror makes it all worthwhile because I'm happy at what I see back.

Nicola - I hope you now how the success you're after and get the weight off, it really is the best feeling in the world walking into shops and knowing there is something in there for you!

Silversurfer - harsh but true, I doubt I would now be eligable for a bypass, it's a depressing thought to think I may just be left out in the wilderness so to speak until my bmi is back to unhealthy again. At the same time, if I just have the band replaced, what is to stop it happening again.

Having said all of that, I wouldn't change it for the world, being slim after years of being overweight counteracts all of the expense!

Thanks for comments

If i were you i'd explore the possibilities of having the band put right in this instance, and let your surgeon suggest the solution, as you rightly say without the band your likely to quickly regain weight, the band or bypass offer us restriction which stops us being able to eat volume, without that how quickly would most of us put the weight back on ?
I think had the band not worked because you had lost self control and regained weight then the next option for you would have been a bypass as some others here have done, but you have made your band work and there's no reason you cant make the next one work to, my only concern really would be the long term failure rate for these bands as your not the first here to have had problems !

 

[Silversurfer]

I found the following interesting.

A recent study revealed that severely obese patients who chose bypass surgery, reduced their risk of premature death by up to 89 percent, compared to equally overweight patients who did not get surgical treatment.

Which is excellent, however:

About 10-20 percent of patients undergoing stomach bypass require follow-up operations to correct complications, the most common complaints being abdominal hernias.
More than one-third of patients who have gastric bypass surgery develop gallstones.
Complication rates in the early post-operative period, such as infection, dehiscence, leaks from staple breakdown, stomal stenosis, ulcers and deep thrombo-phlebitis may be as high as ten percent or more. However, the combined risk of the most serious complications (gastrointestinal leak and deep venous thrombosis) is less than one per cent.
Over the long term, the health complications of gastric bypass may include a variety of conditions and problems. According to one 14-year follow-up study of stomach bypass patients, the morbidity rates were as follows: vitamin B12 deficiency (39.9 percent), incisional hernia, (23.9 percent), depression (23.7 percent), staple line failure (15 percent), gastritis ( 13.2 percent), cholecystitis (11.4 percent), anastomotic problems (9.8 percent), dehydration malnutrition (5.8 percent), dilated pouch (3.2 percent).

Both procedures present a risk of follow up surgery whether its revision or otherwise.

I hope you get something sorted soon brighteyes.

Yep cant argue with that, personally now i'd rather be 26 stone again instead of 12 and not have run the risk of the life threatening bypass !