Lap-Band Revision Surgery: Transitioning to Sleeve Gastrectomy

Many of our Lap-Band® patients have enjoyed successful weight loss over time, as the Lap-Band has proven to be the safest and most effective reversible surgical option for weight loss. However, some individuals have encountered issues such as band intolerance, which manifests as weight regain, band slippage, infections, severe heartburn, and other challenges that hinder their progress toward their weight loss goals.

To address these concerns, Dr. Kuri now offers “Lap Band Revision Surgery” for select patients facing these difficulties. This procedure involves the removal of the Lap-Band and a surgical transition to the Gastric Sleeve.

For patients experiencing Lap-Band intolerance, the removal of the band provides immediate relief from associated symptoms. Nonetheless, without another bariatric procedure, most patients tend to regain weight once the band is removed. Research has shown that weight loss following a revision to Gastric Sleeve Surgery can be as high as 60% compared to pre-band removal weight.

Laparoscopic Lap Band Removal:

Lap-Band removal is conducted laparoscopically and is generally considered a straightforward and safe procedure, contingent on the patient’s existing health conditions. The steps involved in lap band removal surgery are as follows:

  1. Laparoscopic instruments are inserted through small incisions, with the possibility of using the old incisions in most cases.
  2. Scar tissue around the band is carefully cut.
  3. The tubing and band are cut.
  4. The band is extracted from around the stomach.
  5. During the initial operation, the upper part of the stomach (fundus) is typically sutured to the part of the stomach above the band to prevent band migration. Some surgeons leave these adhesions and sutures in place during the lap band removal operation. However, it is crucial to remove these sutures and lyse the adhesions, which restores the original stomach anatomy and facilitates subsequent revisional surgery.
  6. After the band is removed, the perigastric capsule (dense scar tissue around the upper part of the stomach or esophagus) should be removed or incised to reduce the risk of obstruction after surgery.
  7. The subcutaneous port used for band adjustments is also removed.
  8. Following band removal, the surgeon proceeds with the Gastric Sleeve surgery.

Lap Band Conversion to Gastric Sleeve

Gastric Sleeve Surgery involves the permanent removal of a substantial portion of the stomach, typically ranging from 60% to 85% of the total stomach. What remains is a slender tube or “sleeve” that serves as the new stomach. This residual stomach resembles a sleeve or tube, holding approximately 50 to 150ml of capacity, about the size of a banana.

The Gastric Sleeve operates by restricting the amount of food that can be consumed while altering hormonal signals between the stomach, brain, and liver, effectively setting a lower “set point.” As a result, fewer calories are absorbed, and the modified hormonal signals reduce hunger. This leads to weight loss and improvements in overall health and well-being.

Key health benefits of the Gastric Sleeve include:

  • An average of 60% excess weight loss
  • Over 70% of patients experiencing improvement or remission of Type 2 Diabetes
  • Enhanced overall well-being, health, physical activity, and self-confidence
  • Improvements in patients with high blood pressure, sleep apnea, and joint pain
  • Significant enhancements in obesity-related health conditions such as Type 2 Diabetes, High Cholesterol, High Blood Pressure, and Sleep Apnea.