The Lap-Band is among the most common types of bariatric surgery for weight loss in patients with obesity or morbid obesity. There are numerous medically supervised weight loss methods, with surgery usually being the last resort for those who have been unable to lose weight by other methods. Approved by the U.S. Food and Drug Administration (FDA) in 2011, the Lap-Band System includes a silicone band, tubing, and an access port, and is results in the contraction and reduction of the size of the stomach. This reduction in the size of the stomach inhibits the amount of food intake, leading to weight loss. The Lap-Band has also been shown to positively impact Type 2 Diabetes.
Using either a laparoscopic or open surgery, the silicone band is placed around the upper part of the stomach and it is connected to the access port with a thin tube. The band is inflatable and the amount of fluid in the band is adjusted by a physician, limiting the amount of food intake. The Lap-Band surgery is indicated for adult patients with a Body Mass Index (BMI) higher than 40 kg/m2 or a BMI higher than 30 kg/m2 and at least one other comorbidity.
Lap-Band Removal Procedure
The Lap-Band has been the subject of numerous research studies and its effectiveness has been scientifically proven over the past years. The surgery is able to help about 80% of patients lose at least 30% of excess weight and maintain it for a year or more. However, due to complications during or after the surgery, the band must sometimes be readjusted, replaced or removed — a procedure that depends not only on the patient and type of complication, but also on the procedure used during the first surgery.
As part of Lap-Band removal, the surgeon needs to cut the capsule created by the body around the device, remove sutures and any scar tissue formed, as well as the band itself. The band, tube and port will then be removed from the stomach through the incision. If the patient was initially submitted to a laparoscopic procedure, the removal surgery can be performed using the same incisions initially created and will take about 10 minutes. In the case of open surgery, it is likely that the second one will also be an open surgery.
Reasons For Lap-Band Removal
There are two main reasons why a Lap-Band must be removed: either because the treatment was unsuccessful and the patient was unable to lose weight, or because there were complications associated with the surgery or band itself that required the removal. Just like any other surgery, both the Lap-Band placement surgery and the Lap-Band removal surgery includes a series of risks that need to be taken into consideration by both patients and physicians prior to the treatment.
The most common complications that can result in a Lap-Band removal include band erosion during which the band grows into the stomach, a band or port infection not curable with antibiotics, band intolerance revealed by symptoms like excessive nausea or vomiting, band slippage resulting in a bigger pouch than needed, dysphagia or excessive swallowing difficulty, esophageal dilatation or dysmotility, pouch dilation, as well as gastroesophageal reflux disease (GERD), a chronic illness that causes gastroesophageal reflux, heartburn and possible damages in the esophagus.
However, the Lap-Band is designed and approved by the FDA to be used in the long term by patients, and assuming that patients comply with the device’s indications, Lap-Band removal incidents can be kept to a minimum.