Lap Band Eroded - Possible Revision To Gastric Sleeve

[FXDF2008 14]

I have had my band since February 2007. Yesterday, I went in for an upper GI to check and make sure my pouch hadn't stretched. I haven't had any pain or discomfort, no vomiting, or acid reflux. My only complaint was that despite having an almost full band, I could at times eat much more than I thought I should be able to. Hence the decision by my doctor to do the upper GI. As reference, I began at 277 before my lapband surgery. I got down as low as 183, bounced back up to 223 and am now sitting at 211 with a BMI of 32. My goal weight is about 165. This is in a period of almost four years.

When I drank the contrast liquid, we watched as the Fluid went down the esophagus, into the pouch, and through the stoma. We also watched as some of the liquid went AROUND my band! The only way that can happen is if a portion of the band is now INSIDE of my stomach. Preliminary diagnosis is band erosion. Next week I will be scheduling an endoscopy to determine the extent of the erosion and see how much damage has been done to my stomach.

In the brief conversation I had with my doctor after the discovery, he stated that the only option for treatment is removal of the band. You could have knocked me over with a feather. I have become dependent on my band and to think of not having restriction is a scary thought for me. Like others, the thought of going back to the weight I was at before is not an option.

My doctor has indicated that once the band has been removed and I have healed from that surgery (after about four months), I can either be re-banded (I don't think so), or I can do a revision to either bypass or gastric sleeve. I am not keen on the idea of bypass. It just seems so extreme and there's no where to go after that surgery. So I am leaning towards the sleeve. From everything I have read, the majority of people who have had this procedure are very happy with it.

Yesterday was spent trying to wrap my head around the prospect of having two surgeries next year. Talking with my family and trying to understand my options. I am fortunate in that my situation is not an emergency. There is no infection and I can eat properly. (The doctor did deflate my band completely). I also have insurance through my company and the enrollment period is coming up in the next couple of weeks so I can make decisions accordingly knowing that I am going to have these surgeries. It is still yet to be determined if my insurance company (BCBS AL) will cover either surgery (scary thought), but I'm willing to fight for it. I was self pay for my band so I don't know if that will impact their decision or not. I know they do cover WLS and have the typical six month waiting period (not sure I would have to do that given the circumstances).

I will be posting here with my progress and experience for the benefit of others who may encounter similar complications and decisions. I would very much like to hear from others who have had band erosion and have done the revision to the sleeve or those who have the sleeve and what their experience has been with that type of surgery.

I can't believe I'm at this point again. Ugh.

[CowgirlJane 14,259]

This is a tough spot, it is so disappointing when that band fails.

What I wanted to mention is that my company is changing from BC/BS PPO to BC/BS of MA and they specficially exclude the sleeve. You can go on the webpage to find out of BC/BS of AL covers the sleeve

[FXDF2008 14]

Hi CowgirlJane,

I know that BCBS AL does cover the sleeve. I just don't know if they cover revision after band failure especially if the original procedure was either self-pay or covered by another insurer. This remains to be seen.

I am currently waiting for a call back from my bariatric surgeon and have a boatload of questions written down so hopefully things will be somewhat clearer this afternoon.

[FXDF2008 14]

Spoke with the M.A. at my surgeon's office this afternoon. Asked the following questions and received the following answers. If anyone can suggest other questions I should ask when I meet my surgeon, I would appreciate it very much.

1. From your experience, are removals and revisions generally covered by employer insurance even if the original surgery was either self-pay or covered by another insurer?

A. Removals are usually covered as they are considered a complication and medically necessary. Revisions depend on the coverage.

2. If they do cover the revision, do they typically require the mandatory six month weight loss program requirement?

A. Insurance requirements are rapidly changing - hard to say at this time.

3. Pending the results of the endoscopy, would it be harmful to wait until my new benefits take effect at the beginning of the year before removing the band?

A. Depends on the results of the endoscopy

4. Could the removal and revision be done at the same time?

A. No. You need time to heal from the removal

5. How many removals and revisions has my surgeon done?

A. Quite a few (no numbers provided, will ask surgeon directly)

6. Generally, how long is the recovery for the removal and for the revision to the sleeve?

A. Removal of the band, about the same length of time when having the original surgery. Revision depends on the patient.

7. Is the removal procedure inpatient or outpatient?

A. Usually outpatient

8. Typically, how long is the hospital stay for the revision.

A. Overnight

9. Is there a stomach tube with the revision? How long does it stay in?

A. Sometimes. Depends on the patient.

She informed me that she will contact my PCP in the morning to make sure they have all the information they require in order to make the referral for my endoscopy. They want that done ASAP.

She also suggested that I speak with a rep from BCBS during open enrollment to discuss my specific situation and what actions I need to take to assist in getting approved for the revision.

I know that everyone's situation is unique and everything I asked here may not apply to your situation, but I hope that my experience can help others in similar situations.

[Becca 108]

So sorry about your band. I understand because I have been right where you are. I self paid for my band because WLS was excluded from my insurance when I had it. We had some policy changes and when my band eroded and broke apart, my insurance agreed to cover the removal right away. I had to wait three months for a decision on the sleeve from my insurance. It was painful waiting because of the broken tubing, but I wanted to have the entire surgery at once. I would see if you can find a doctor that can remove the band and do the sleeve at one time. My band was pretty bad and my doctor was able to do it. It is possible if you find a revision specialist. Good luck. The sleeve has worked amazingly well for me. I don't miss my band one bit! Fight for the sleeve! Having my revision was one of the best decisions I could have ever made for myself.

[FXDF2008 14]

Went for my upper endoscopy today. Band erosion confirmed. You can clearly see half the band on the inside of my stomach. Will be meeting with my surgeon soon to come up with a plan of action.

Here's hoping my insurance will cover revision to the sleeve.

[Pegsinthewoods 8]

I, too, am an eroded lapband survivor. Being without my band sucks! I have already gained 28 pounds since April. My band was severely eroded and I had a bad case of peritonitis so my doc is having me wait until next April to be sleeved. Due to the peritonitis, he expects lots of adhesions and he has found he has better results when adhesions are at least a year old. They become more pliable so there's less chance for leaks. Anyway, I am hanging on the best I can until April.

[kekerene 35]

I did not experience erosion with my band but my band did slip after 4 years. I had the band removed and the revision to the sleeve done all in 1 surgery. I too was self pay for the band and again for the revision surgery. I cannot even tell you how pleased I am with the sleeve versus the band. I really lived a poor quality of life with the band. I never got close to goal weight, I lost and then gained weight, I could not keep any solid foods down, it was just plain horrible. My life has changed with the sleeve and I am sure your will as well. Best of luck to you!

[FXDF2008 14]

It has been a while since I have written, but it's been because I've been in a holding pattern waiting for my new insurance coverage to kick in. Fortunately, my band hasn't given me any issues besides some minor pulling feelings and twinges. I have had no sign of infection thus far thankfully.

While I was waiting for the updated insurance, I gave a great deal of thought about who I wanted to do my surgeries. The doctor I had been going to for my band maintenance is a capable surgeon and a nice enough person, but I wasn't comfortable with his level of expertise in doing band to sleeve revisions. I did some research and found another surgeon here locally who has been doing sleeves for more than four years and has been doing band to sleeve revisions about once a month and is doing them on an increasingly frequent basis. In his words, a band to sleeve revision is not bariatric 101 surgery. It is more complicated due to scar tissues and adhesions from the band. I like his forthright attitude and his confidence, so I am waiting for a call next week to schedule the first surgery to remove the band. We will then wait three to six months and do the revision to the sleeve.

He indicated that he will probably keep me overnight in the hospital for the band removal as he uses a stomach tube for drainage and that will need to be removed and he also wants to make sure there are no leaks. However, he also said that in all likelihood I can have the surgery on Friday and be back to work the following Monday as long as I have a sedentary job which I do.

I am ready to get this process started. Let's do this thing!

[CowgirlJane 14,259]

I am so glad you found an experienced revision surgeon. I am shocked he thought you could go back to work after so few days... I sure couldn't!

I went back to work after 3 weeks, desk job, and have really struggled due to exhaustion.

[FXDF2008 14]

I am so glad you found an experienced revision surgeon. I am shocked he thought you could go back to work after so few days... I sure couldn't!

I went back to work after 3 weeks, desk job, and have really struggled due to exhaustion.

He stated that it would just be a few days for the band removal. We haven't talked about the sleeve surgery in detail as of yet but he seemed to think my recovery from that would be fairly quick as well. From what I've read on various sites, this doesn't seem to be the case. Fortunately, I am able to work from home if I want or need to.

[Bobbi Lou 0]

I had my band placed in october of 2010 then in the last week of December of 2011 my band slipped I did have good sucess with the band. The following week my doctor scheduled me for surgery. which was this past Wednesday 1-6-12. He removed the band and and he said it was the "worse case" senerio and I had to be converted to a gastric sleeve. I am still reeling in my mind over this decision. To hear that others have gone thur this and have come out ok. Makes me feel alot better. Thanks for sharing and allowing me to share with all of you.

[CowgirlJane 14,259]

okay, gotcha, I misunderstood - I thought you were doing the revision in one surgery. So, here is my story - I had my band removed on a Thursday in September, I returned to work the following Monday. I was feeling poorly, I think reaction to the anesthesia (and maybe even a little depression over the whole band failure?). I was okay, sorta, but then got sick with a virus. I wound up working Mon-Wed that week and taking Thurs and Friday off. i think if I hadn't gotten that virus, I would have been okay with just the "long weekend" to recover.

The port incision was sore for awhile though.

The other thing that happened was that starting about a week after the band came out, my hunger went through the roof. I hadn't had Fluid in my band for years, but once it was removed, I felt like my stomach was a bottomless pit. I finally got control over the weight gain by doing a low carb thing with my family doc, just to kinda hold me over until I was sleeved.

For me, the Sleeve was a much harder recovery. Part of the reason for that is you have very restricted Fluid and calories - so in addition to all the surgery recovery you just aren't getting the fuel you are used to getting!

Some people bounce right back and go to work in a week or so after the sleeve surgery. Many people needed more time, I am one of them even though I didn't have any complications. I am almost 4 weeks out, have been back at work for a week and am just exhausted. Some days are better, some are worse, but I am certainly not back to my normal self.

Having said all that, I still think it is worth it. I am already enjoying being a bit lighter on my feet!

He stated that it would just be a few days for the band removal. We haven't talked about the sleeve surgery in detail as of yet but he seemed to think my recovery from that would be fairly quick as well. From what I've read on various sites, this doesn't seem to be the case. Fortunately, I am able to work from home if I want or need to.

[CowgirlJane 14,259]

I hope you are recovering well. I think the gastric sleeve is a great choice when you need to get rid of the lapband.

I am not sure I understand the worst case comment - you weren't planning on having the sleeve procedure done?

I had my band placed in october of 2010 then in the last week of December of 2011 my band slipped I did have good sucess with the band. The following week my doctor scheduled me for surgery. which was this past Wednesday 1-6-12. He removed the band and and he said it was the "worse case" senerio and I had to be converted to a gastric sleeve. I am still reeling in my mind over this decision. To hear that others have gone thur this and have come out ok. Makes me feel alot better. Thanks for sharing and allowing me to share with all of you.

[*susan* 1,709]

I too am a band to sleeve revision. I have to tell you, it was the best thing that ever happened to me. I had nothing but problems with the band, and in all honesty, could not and would not ever in good conscience recommend it to anyone.

My surgeon did the band removal and revision to sleeve at the same time. There was no way I would have been able to return to work after just a couple of days. I could possibly see that with just having the band removed, but not after you have the sleeve done. You don't want to push it. The main thing I found was I was terribly weak from the lack of food. I had no energy and there was no way I could have functioned at work.