Adjustable gastric band: Removal, revision, conversion

An adjustable gastric band, also known as lap band, is a bariatric procedure that reduces the stomach’s capacity to hold food. Patients will therefore feel full sooner and limit the amount of food intake.

Today, adjustable gastric band is considered an outdated procedure and many doctors and facilities have stopped offering this treatment, including our bariatric specialists at KCM Clinic. There are other advanced, more effective weight-loss surgeries available that have proven to give better outcomes.

In this article, we are going to delve into gastric band removal, how it works, and what other bariatric procedures can be performed when undergoing a revision.

Adjustable gastric band: How does it work?

Adjustable gastric band surgery involves placing a silicone ring around the upper part of the stomach. Here, the surgeon creates two pouches, one smaller in the upper part, and one bigger below. A “port” is then attached to the band to inject a saline solution into the band. This allows the doctor to calibrate how tight the band should be. The band remains in place but will have to be removed after a few years or if complications arise.

When is it time to remove a gastric band?

If you had gastric band surgery and are wondering whether it’s time for you to have it removed, you can contact our specialists at KCM Clinic anytime, who will advise you on the best course of action.

Typically, a gastric band is removed for one or more of these reasons:

• You’re not losing as much weight as expected or you are regaining weight: studies have shown that the gastric band is not as successful as other bariatric procedures such as gastric sleeve or gastric bypass. Many patients have reported limited weight loss or complications.
• Complications: the band may slip off or deteriorate, causing infection or intolerance.
• Band lifespan: as a medical device, the lap has shelf life and needs to be removed after a maximum of 10 years.
• Band intolerance: you have been experiencing excessive nausea or vomiting or feeling discomfort and/or pain for a long time.
• Band erosion: the band grows into the stomach and needs to be removed as soon as possible.
• Esophagitis (inflammation of the oesophagus) or difficulty swallowing (also known as “dysphagia”).
• Gastroesophageal reflux disease (GERD).

How does gastric band removal work?

Most gastric band removal procedures are performed laparoscopically. This means that the surgeon will access your stomach by making 5 or 6 small incisions in your abdomen. If you had a laparoscopic procedure, the surgeon can use the old incisions.

A gastric band removal is typically a quick procedure and shouldn’t take more than one hour to perform. Here’s how a gastric band removal works step by step:

1. The procedure is performed under general anaesthesia, so you will be asleep throughout the surgery.
2. The surgeon will insert the laparoscopic instruments to access your stomach.
3. Any scar tissue that may have formed will be cut.
4. The surgeon will then cut the band and pull it out from around the stomach.
5. Any adhesions and sutures from the initial surgery will be removed.
6. The port will also be removed and the incisions will be closed.

What are your options if you need to remove an adjustable gastric band?

Patients who undergo a gastric band removal may have another bariatric procedure performed during the same surgery. Bariatric revision surgery includes gastric band conversion to a gastric sleeve or a gastric bypass. The revisions procedure may take place also at a later stage, typically 3 months after the gastric band removal. Our specialists will evaluate this possibility on an individual basis.

After a gastric band removal, your stomach will go back to its original size and most patients regain weight. This is why a bariatric revision surgery may help you continue your weight-loss journey.

Adjustable gastric band to gastric sleeve (sleeve gastrectomy)

The gastric sleeve, or sleeve gastrectomy, is today’s most popular bariatric procedure. The procedure involves removing around 75-80% of the stomach, leaving a banana-shaped pouch that is stapled back together. The aim of a gastric sleeve is to make you feel full sooner as the size of your stomach is smaller. The digestive functions of your stomach are not altered. This procedure is non-reversible and has helped hundreds of patients lose weight successfully.

Adjustable gastric band to gastric bypass

Gastric bypass, also known as Roux-en-Y gastric bypass, is a bariatric surgery that alters your stomach. During a gastric bypass, the surgeon divides the stomach into a small pouch that will be connected directly to your small intestine, speeding up absorption and digestion. Another similar weight-loss procedure is the mini gastric bypass, which combines some elements of the gastric sleeve and the gastric bypass procedures.

What are the advantages of converting to a gastric sleeve or gastric bypass?

Bariatric procedures such as gastric sleeve and gastric bypass have proven to help patients achieve far better outcomes than gastric band. The advantages of converting to a gastric sleeve or bypass include:

• Better weight loss achievements: while the gastric band seems to have positive results in the short term, it may lead to weight gain or complications over time. Gastric sleeve or bypass, on the other hand, provide a steady weight loss of around 30-40% of a patient’s body weight.
• Low complication rate: as mentioned earlier, the gastric band can’t be considered a long-term solution, as the band itself needs to be removed at some point. Moreover, complications are very likely. On the contrary, the long-term complication rate of a gastric sleeve is extremely low.
• More sustainable post-op journey: severe side effects after a gastric sleeve are very rare. Moreover, the final results of gastric band surgery are highly influenced by the patient following strict guidelines and having regular follow ups with their doctor. While all bariatric surgeries require the patient’s full commitment to changing their lifestyle and eating habits, gastric sleeve and gastric bypass post-op journeys are typically more manageable thanks to low complication rates and minimum follow ups.