Slippage - Need Feedback

[Tuff Enuff 0]

Yes it can happen to either type of installation with the band. Mine was the one where they sutured the tissue over the band to try to prevent that from happening. It happened anyway, I'm part of the percentile they tell you about. I had to have mine removed February 2 due to the slippage being severe enough by then I had been five days without even fluids. I'm doing alright now but am bandless and pretty bummed out with the bills still rolling in for the emergency surgery. I've been totally self pay and am feeling a tad bitter.

Slippage is where part of the stomach below the band works its way up above the band. Sometimes it can be repaired by simply removing all of the fill and (if there is enough space) it will move back down through the band back to it's original position. They tried that with me but my band was tight enough to begin with that we never made it past a .3 fill.

I'm a band failure and am pretty blue.

[SusanP 0]

I tried to eat beef for the first time yesterday. I took small bites, mushed it up well, but I had quite a pain in a different part of my stomach afterwards, and was a bit sore. It seems to be ok today, but I am very curious about symptoms of slippage! Thanks

[DrPleatman 3]

Donna

I'm a surgeon and I don't even understand your explanation. We place the sutures from the stomach above the band to the stomach below the band. The suture pulls the stomach over the band creating a tunnel of stomach through which the band goes. The band can slip if the sutures pull loose or if there aren't enough of them.

Mark Pleatman MD

[mini_me 3]

Donna

.... The band can slip if the sutures pull loose or if there aren't enough of them.

Mark Pleatman MD

Dr. P:

Is this the only way slippage occurs with this method?

[Tuff Enuff 0]

Hi All:

That was the way it was explained to me... that part of the lower stomach comes up through the banded area and lies off to the side, this causes a kinda catch basin where stuff sits way too long, it can drain or in my case "not".. In my case some things would go through... mushies...liquids, sometimes not and then I would have bouts of vomiting. I suspected slippage in Oct/Nov when the episodes of vomiting got closer and closer together and I couldn't seem to tolerate much beyond mashed potatoes and things of that consistancy. Even milk beverages sat too long and would clabber which would cause blockage which you guessed it caused vomiting. Eventually nothing would pass through and basically it was my saliva coming up. Never nausea, think taking a cup and no matter how quickly or slowly you pour a liquid or any other substance in eventually it will fill up and overflow. Nasty!

When I spoke with my surgeon he never mentioned the sutures holding the stomach over the band coming loose. Apparently the slippage happened sometime between September and November. I was banded in May. Diagnosed 12/9/05 and had emergency removal 2/2/06.

[Pamela218 0]

Has anyone heard of a prolapse? I don't know if that's the same as slipping or not. I've had all the Fluid from my band removed. One week of liquids and one week of mushies. Then they will recheck me. Has anyone had theirs fix itself?

Just wanting to know what to expect.

[DrPleatman 3]

Pam

Sorry to be the bearer of bad news, but prolapse is the same as slippage. You will need another operation to fix it. The good news is that slipped bands don't need to be removed; they can almost always be fixed with an operation that is as easy for you as was the first one.

Mark Pleatman MD

[em1125 0]

Hi Dr. Pleatman

I'm new and I'm concerned. I'm having my band put on in July, 06. How does slippage occurr and why?

Emily

[DrPleatman 3]

Emily:

As I said previously, slippage occurs because of either not enough sutures in the right place, or (possibly) frequent vomiting or overeating. Ask your surgeon what his percentage of slippage is.

Mark Pleatman MD

[em1125 0]

Thanks very much. I will do that.

[Kayford 0]

There is such a thing as "Dynamic Slippage," where a slipped band un-slips after it is unfilled. It may stay unslipped for a long time as long as it is not refilled. There is probably no urgency about doing something, though there is no reason to wait.

Slipped bands can generally be fixed immediately... there is no reason at all to wait. You can use the same band again, as long as you don't damage the band while dissecting the adhesions (scar tissue)around it.

I take care of a fair number of patients who have been banded in Mexico, and try to be sensitve to money issues. I am very nervous about repairing slips and risking re-slippage; I have one patient now whose band I did with Dr. Ortiz, and she now has a dynamic slippage. She wants it fixed. I'll to my best to do what she wants, but my preference would probably be to convert to gastric bypass. It's cheaper and doesn't fail. So far I have coverted 14 band patients to bypass... for various reasons such as slippage, erosion, or just failure to lose weight, and all are happy now.

Mark Pleatman MD

www.laparoscopy.com/pleatman

248-334-5444

We are so lucky to have some surgeons that post on this site and help us out. Dr. Pleatman why do you think one gets a slip? I am self pay and banded by Dr. Ortiz. Is it always the patient's fault? I wish we understood more about "WHY" a band slips. I have no reflux but do have some pb's on meat occasionally.

[girlinnyc 0]

I just found out that i MAY have a slipped band. i had a violent vomiting episode last week--and afterwards--i felt no more restriction.

Today i had an esophogram--and it wasn't clear enough to see if the band had slipped. it MIGHT have---so i am having an endoscopy on Thursday to get a clearer picture.

What does an endoscopy show that will make it even clearer than an esophogram? does anyone know?

this is depressing. i really don't look forward to another surgery.

[Tangoempress 0]

HI There

I was wondering if anyone has any experience of having their band surgically adjusted after slippage.

I have been so fortunate with my band, had it installed in Sept 06, with Dr. Ortiz, Mexico and have reached my goal 155lbs. However during the last 9 months or so I have had various incidents with major acid reflux that have been addressed by unfills, bottom line, now I am out of unfills. I am not able to eat anything but liquids and still have some reflux issues and a whole lot of retching. My Dr. here thinks that my band has slipped but wanted to wait a month after my complete unfill to see if it adjusted itself. But its now 2 weeks later and I am not able to eat enough to maintain my weight. I am down to 147. I am not sure if my insurance would cover a surgical adjustment or if necessary a complete removal. It may well be that I will have to go back to Dr. Ortiz. So I am looking down all avenues and would welcome any input.

Thanks

Tangoempress

[DrPleatman 3]

If your band is completely unfilled and you still can barely tolerate liquids, it has probably slipped. The barium swallow x-ray is generally reliable in making the diagnosis. If this is the case, you need an operation. Dr. Ortiz would probably replace/repair the band. My personal preference would be, as I have said before, to remove it and convert to something else. Most band patients don't like the idea of a gastric bypass, so I have been converting to sleeve gastrectomy. I know that this isn't what you want to hear, but that's my honest opinion.

If you don't have insurance and have to pay for it yourself, it will cost around $12000.

Mark Pleatman MD

Index

248-334-5444

[morningoasis811 1]

Hi Tango and Dr. Pleatman,

I found out in early January after an upper GI barium swallow, that my band had slipped. My surgeon took out 1.2cc's of Fluid which left me with 3.8cc's in a 10cc band. Highest fill level I had was about 6cc's. Two unfills over last summer and I had been perfectly fine all fall until christmas eve and have been suffering ever since.

I felt better after the unfill for a couple weeks, then the reflux, pain an heartburn all kicked back in again. I got an appointment with my surgeon this past Wednesday. From reading on here I was expecting that next step would be remove all Fluid, wait to see if it fixes itself... then consider surgery for a fix. He said, no unfill because I would just be back to see him in two more weeks with the same problem.

I'm now scheduled for surgery this next Tues 3/3 for a fix or worst case removal. I advised him that I would strongly prefer to keep it. I've been really successful to this point. He said that if he had to remove it, he would most likely have me wait 6 months to heal and then consider doing a gastric sleeve. He thinks that would work great for me.

I'm at my goal weight pretty much right now. I've lost another 6 pounds this last few weeks from not being able to eat much. 15 pounds total since christmas when i first noticed the pain. I'm worried about losing more after surgery if I keep the band. I'm worried about having it removed and instantly gaining all my weight back. I'd like to think that i'm stronger now and wouldn't regain, but it seems the odds are against me no matter how hard I try.

:confused:Dr. Mark Pleatman,

Do you think it's odd that my surgeon skipped a complete unfill and went straight to a fix surgery? What are the chances of me being able to maintain my weight loss after removal? If I got the gastric sleeve at goal weight, could i maintain because my volume would be the same or would I lose more?

Your posts here are very helpful. thank you all for sharing. This has shook me this week with thinking i was having an unfill and then having surgery within 1 week. Crazy.

Edited February 28, 2009 by morningoasis811
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