Band Eroded And Removed...beyond Blue.

[bound45k 0]

I was banded 10/04/11 and between then and August '12 lost about 40lbs. In November I had redness and pain in my port area and my surgeon put me on an antibiotic and the pain and redness resolved. Then about 3 different times between November and August, I would have pain in the port area that would go away the next day after applying heat. Finally, though, in August the pain would not resolve and taking extra strength tylenol did not touch the pain. My surgeon started me on pain medication and his office went to work trying to have a port revision covered through my insurance.

I paid cash for my original surgery. After a month, I was finally scheduled for an EGD and possible port revision, but when the doctor did the EGD he learned that the band had eroded into my stomach around the buckle area. This was on a Tuesday and by Thursday I had the band removed and spent 5 days in the hospital. I am not going to sugar coat it, it was awful. I've had surgeries before but this was the most difficult. In fact, it's now 5 weeks later and I'm still dealing with a lot of pain. The surgeon said that this was a very difficult surgery that would require a long recovery. He also said that if I wanted to in about 6 months I could revise to the sleeve.

I am extremely down about the whole ordeal. I am so tired of being obese. I have tried every diet/program out there and have not been successful to become thin and healthy. That is why I took such drastic measures in getting the lapband, I need help outside of myself. So, I don't know what to do now. The lapband surgery was difficult, the removal was even more difficult and to consider another surgery scares me. Thanks for "listening"...I just don't know what to do. =(

[Shackwacky 72]

Aww that's awful. Sorry you had such a terrible time.

[bound45k 0]

Thank you.

[lassie 247]

Oh Hon I am so sorry, I cant tell you what to do. I can pray that you talk to your doctor and between the two of you you will know what is best for your health. Lots of hugs

[lassie 247]

please keep posting so that we know how you are doing, we do care.

[Darbyjack 5]

Oh my gosh. I am so sorry that you have had to endure this endless suffering. I pray that you have some peace soon. Come to a decision with your Doctor, even a 2nd opinion if it would make you feel better. Quality of life is so precious. I wish you luck and peace. Add me as a friend, if you just need to vent, or whatever you need. I am a pretty good listener. ((((hugs))))

[Doweegirl 11]

Sorry for all your pain. Do they know why it eroded in such a short time? Give yourself sometime to heal and to think.

[bound45k 0]

Thanks for your kind words and support. Doweegirl, the surgeon thinks that my body just rejected the foreign object. The hole into my stomach was at the buckle, so I think perhaps it was a sharp area and it just cut through. I know it's almost unbelievable that I would have an erosion in such a short amount of time. At first, while I was still in the hospital after the surgery I couldn't even conceive of having another surgery when the surgeon mentioned it. But now 5 weeks out I am seriously considering it, of course I'll have to wait several months. It just feels hopeless, you know? I hate my body. I know that's harsh, but it's how I feel. And I'm frustrated. Thanks again for listening.

[Baba Wawa 543]

The Lapband doesn't have "sharp" edges...I would ask discretely for your surgical reports/videos. Damage can be done to the stomach/band at surgery, if its not installed properly. Unfortunately, when we are self pay, the focus is on price rather than experience especially with the band since its marketed as "safe". With your issues early on with the band, I'm suspicious that you had a band and/or stomach that was damaged. Port pain is indicative of a leak somewhere in the system, subsequent infection and erosion. This isn't your fault.

Implantation instructions for Lapband from Allergan's website:http://www.allergan.com/assets/pdf/lapband_dfu.pdf

to expose the esophageal hiatus, the anterior stomach, and lesser omentum.

Measurement of the Pouch: The anesthesiologist passes the calibration tube down into the stomach and inflates its balloon with 25 cc of air (some surgeons prefer saline). The balloon

is withdrawn upward until it is against the gastroesophageal junction (Figure 7).

Introduction and Placement of the Band: The inflatable band and Access Port are flushed with sterile saline (see “Band Preparation” and “Access Port Preparation”). The band is introduced into the abdomen via a 15 mm or 18 mm trocar. The band is pulled, end plug first, into place around the stomach with the instrument previously placed through the retrogastric tunnel (Figure 11).

The tubing is inserted into the band’s buckle. The band is locked in place using atraumatic graspers.

CAUTION: Failure to use an appropriate atraumatic instrument to lock the band may result in damage to the band or injury to surrounding tissues.

Opening or Unlocking the LAP-BAND AP® System: The LAP- BAND AP® System provides for the re-opening of the band in the case of slippage or malposition. With atraumatic graspers, stabilize the band by grasping the ridge on the back of the band.

Figure 12. Unlocking the LAP-BAND AP® System

With the other grasper, pull the buckle tab up (see Figure 12) and slide the tubing through the buckle until there is ample area to adjust the position of the band.

CAUTION: Failure to create a new tunnel for the band during repositioning may lead to further slipping.

retention Gastro-gastric Sutures: Multiple non-absorbable sutures are placed between the seromuscular layer of the stomach just proximal and distal to the band. Sutures should

be placed from below the band to above the band, pulling the stomach up over the band until the smooth surface of the band is almost completely covered. The tubing and buckle area should not be included in the gastro-gastric imbrectation (Figure 13).

Ridge

Tab

Figure 7. Calibration Tube balloon withdrawn upward against the gastroesophageal junction

This permits correct selection of the location along the lesser curvature and into the phrenogastric ligament to perform the blunt dissection (Figure 8).

Figure 9. Dissection of the lesser curvature

Under direct vision, the full thickness of the hepatogastric ligament is dissected from the gastric wall to make a

narrow opening. The posterior gastric wall should be clearly recognizable. The dissection should be the same size as the band or even smaller to reduce the possibility of band and/or stomach slippage.

Dissection of the Greater Curvature: A very small opening is created in the avascular phrenogastric ligament, close to the gastric wall at the Angle of His.

retrogastric Tunnel: Always under direct vision, blunt dissection is continued toward the Angle of His until the passage is completed (Figure 10).

Figure 8. Calibration Tube balloon and dissection point selected

Lesser Curve Dissection Options

recommended Technique

PArS FLACCIDA: Dissection begins directly lateral to the equator of the calibration balloon in the avascular space of the Pars Flaccida. After seeing the caudate lobe of the liver, blunt dissection is continued under direct visualization until the right crus is seen, followed immediately by the left crus over to the Angle of His.

The PArS FLACCIDA technique is recommended as it is the most widely used method for laparoscopic adjustable gastric banding and results in a reduced incidence of gastric prolapse and pouch dilatation compared to the PErI-GASTrIC technique (described below).

Alternate Techniques

PErI-GASTrIC: Dissection starts directly on the lesser curve at the midpoint (equator) of the calibration balloon. Dissection is completed behind the stomach toward the Angle of His under direct visualization, taking care to avoid the lesser sac. retro- gastric suturing is an option (Figure 9).

PArS FLACCIDA TO PErI-GASTrIC: Dissection begins with the pars flaccida technique (above).

A second dissection is made at the midpoint (equator) of the balloon near the stomach until the peri-gastric dissection intercepts the pars flaccida dissection. The band is then placed from the Angle of His through to the peri-gastric opening.

Figure 10. Posterior instrument passage

WArNING: Do not push the tip of any instrument against

the stomach wall or use excessive electrocautery. Stomach perforation or damage may result. Stomach perforation may result in peritonitis and death.

WArNING: Any damage to the stomach during the procedure may result in erosion of the device into the GI tract.

CAUTION: Do not over-dissect the opening. Excessive dissec- tion may result in movement or erosion of the band. A blunt instrument is gently passed through the retrogastric tunnel.

Figure 11. Placement of the band

Figure 13. Suturing the greater curvature over the LAP-BAND® System and pouch

Access Port Placement and Closure: The band tubing is brought outside the abdomen and is connected to the Access Port. The port is then placed on the rectus muscle or in an accessible subcutaneous site. The tubing may be shortened to tailor

the position of the port to the patient while avoiding tension between the port and the band. The two components are joined with the stainless steel tubing connector. Ligatures may be

10

[bound45k 0]

Hi MissMaui, thanks for your response. Yeah, the sharp buckle was my own surmising. My surgeon has over 20 years of experience with wls so it may have been something that happened during the intitial surgery. I also had hiatal hernia repair at the same time (billed and covered by my insurance). I saw the surgeon yesterday for follow-up and he again reiterated that this recovery will be a long one. On one hand it's comforting knowing that still feeling crummy is normal but disappointing for the same reason. =) I have to have another Catscan and labs done because I still have quite a bit of pain when he mashed around on my belly yesterday.

I didn't mention in my original post that I had also had to deal with pleural effusion and a collapsed lung--not fun.

[Scorpio Girl 88]

Hope you recover quickly and completely!

[JennyBee 340]

Bound... Sorry ur going through this!

Do you also have to pay out of pocket for the sleeve?

[carlavdm 0]

Hi MissMaui' date=' thanks for your response. Yeah, the sharp buckle was my own surmising. My surgeon has over 20 years of experience with wls so it may have been something that happened during the intitial surgery. I also had hiatal hernia repair at the same time (billed and covered by my insurance). I saw the surgeon yesterday for follow-up and he again reiterated that this recovery will be a long one. On one hand it's comforting knowing that still feeling crummy is normal but disappointing for the same reason. =) I have to have another Catscan and labs done because I still have quite a bit of pain when he mashed around on my belly yesterday.

I didn't mention in my original post that I had also had to deal with pleural effusion and a collapsed lung--not fun.[/quote']

Hi- i am 3 weeks post op after complete revision. Mine slipped and appearently twisted- after 2 trips to ER it was removed. The doc said that if I got to hom 24 hrs later, my stomach would jave perforated. Bottomline- I understand your pain and depression. I have had pancreatites long ago- but nothing compares to the pain i have now. Doc finally said recovery will take longer than anticipated etc etc. We finally figured put the pain is caused by gas. My hubby now burbs me like a baby. It hurts- but helps. Not sure if its caused by surgery or food

Anyway- i also have to Reinvent myself. This was my last option and not even want to go through another surgery and more pain!!!

Thinking of you/ you r not alone in this

Carla

[bound45k 0]

JennyBee, if I go the route of the sleeve then I'll try to go through my insurance. But, I'm leaning more toward not having the sleeve done as the days go by. I still have a lot of pain and tomorrow will mark 6 weeks post-op. In fact, I have a cat-scan and labs scheduled for tomorrow morning to see what's going on...

Carla, I am so sorry to hear of your suffering and appreciate your words of sympathy and encouragement. I had HORRIBLE gas pain for several weeks following my original lapband surgery--the tubing was pressing against my diaphragm, the surgeon could visualize it through flouroscopy. It eventually resolved, but it was truly awful. I, too, have experienced pancreatitis about 5 years ago and at the time felt/thought nothing could ever be worse than that, but I rate my current experience as far worse. And it just keeps going and going. And I'm gaining weight which is incredibly upsetting. I'm thinking of you and pray that you heal completely and swiftly. --April

[tym4me 206]

Bound i am so sorry for all you have been going through. I was banded a week after you i totally understand with having a negative selfbody image. We do get tired of trying so many things an getting no where.

Its more than just calorie intake vs whats burned.

I had suffered with a "mysterious" condition for years Drs got to the point of thinling it was all in my head. Finally at 28 i was Dx with Fibromyalgia that was almost a decade ago. So in the end as with your port if we know something is wrong trust ourselves an keep going to the drs

Other than the port did you have any signs of an erosion? I hope things get better for you soon. If you just need to talk or vent feel free to pm me.

Take care