Lap-Band Failure Rates

[fabfatgrl 10]

OK, as somebody who has been banded 6+ years, I have to say that at least 60% of the people I know who were Banded around the time I was Banded or soon after no longer have their Bands. I know that if I post something like this in the General forums... I get a lot of hands over eyes and mouth saying "no no no ... that can't be true..." because most newly Banded people do not want to hear this. I can't find any concrete statistics from Inamed/Allergan.. nor do I think they keep them (or want to keep them)... but I did find this study:

A 10-year experience with laparoscopic gastric ban...[Obes Surg. 2006] - PubMed Result

RESULTS: Between June 1997 and June 2003, LGB was performed in 317 patients, 43 men and 274 women. Mean age was 38 years (19-69), mean weight was 119 kg (79-179), and mean BMI was 43.5 kg/m(2) (34-78). 97.8% of the patients were available for follow-up after 3 years, 88.2% after 5 years, and 81.5% after 7 years. Overall, 105 (33.1%) of the patients developed late complications, including band erosion in 9.5%, pouch dilatation/slippage in 6.3%, and catheter- or port-related problems in 7.6%. Major reoperation was required in 21.7% of the patients. The mean EWL at 5 years was 58.5% in patients with the band still in place. The failure rate increased from 13.2% after 18 months to 23.8% at 3, 31.5% at 5, and 36.9% at 7 years. CONCLUSIONS: LGB appeared promising during the first few years after its introduction, but results worsen over time, despite improvements in the operative technique and material. Only about 60% of the patients without major complication maintain an acceptable EWL in the long term. Each year adds 3-4% to the major complication rate, which contributes to the total failure rate. With a nearly 40% 5-year failure rate, and a 43% 7-year success rate (EWL >50%), LGB should no longer be considered as the procedure of choice for obesity. Until reliable selection criteria for patients at low risk for long-term complications are developed, other longer lasting procedures should be used.

I guess I'm feeling bad because I one person I tried to convince to try the Band has just had to have her Band completely unfilled due to severe reflux... and she is barely one year out. She's loss maybe 40% of what she needed to, but is now, regaining. I think that so many of us try to paint the Band as positive that we don't talk about the negative... and that we don't accept/realize that this surgery really isn't successful for a lot of people... this study shows a nearly 43% failure rate at 5 years.

Laparoscopic adjustable gastric banding versus Rou...[surg Obes Relat Dis. 2007 Mar-Apr] - PubMed Result

"Weight loss failure (BMI >35 kg/m(2) at 5 yr) was observed in 9 (34.6%) of 26 LAGB patients and in 1 (4.2%) of 24 LRYGB patients (P <.001). Of the 26 patients in the LAGB group and 24 in the LRYGB group, 3 (11.5%) and 15 (62.5%) had a BMI of <30 kg/m(2), respectively (P <.001)."

This study shows a failure rate of 35% at 5 years for the Band.

I wonder what the real figures are. I'd love to know.

[NeenBand 7]

Wow, I have to say I wish I knew this before I was banded. :-/

[fabfatgrl 10]

Wow, I have to say I wish I knew this before I was banded. :-/

I'd get flamed beyond belief if I posted that in the general forums. :eek: But having said that, you may have completely different results...and I hope you do. I think that the Band works as promised for maybe 1/3 of patients. It works OK, but maybe not great for another 1/3. (These people lose some weight, but may still be MO or obese... or they lose weight but have to live with an amazingly bad quality of life in terms of food intolerances, reflux, etc. And for the final 1/3, it sucks. But that's just my opinion.

I'm in the middle category, BTW.

[Alexandra 55]

You know, I really feel like I DID know this before I was banded and it didn't make one iota of difference to me. Not being a cockeyed optimist, I honestly explored and considered all the possible outcomes and how I'd face them if they happened. Well, one of those "negative" outcomes did happen to me, and even if I hadn't been rebanded I'd still have felt that my first 3.5 years with the band had been totally worth all the effort.

Look: NO DIET METHOD IS GUARANTEED. We have to consider the pros and cons of each for our own personal situation. For some proportion of people, the insertion of an artificial gatekeeper to help control portion size is exactly the right treatment. For many other people, it's not going to work well for one reason or another, or turn out to be permanent. I always knew there was a chance the band might have to come out someday, but I also knew that if that happened I'd still be whole and healthy. It happened, I lived, and four months later I've been rebanded even after having the "worst" happen. Because for ME, those 3.5 years with the band have been the only time in my life that I felt I had any sort of handle whatsoever on my personal battle with food.

I completely believe those statistics. It's because of those stats that I wouldn't have been willing to remortgage my house to self-pay; I wouldn't have been willing to travel to Mexico and take on the continued expense and hassle of finding aftercare. For me, it was insurance or nothing. But then, I wasn't at a point where my obesity was threatening my life--it was only threatening to do so in the future. If I had been, the calculus would have been different.

I'm glad you posted this (and don't think it matters what section it's in--it will show up in New Posts regardless). It's important information that people need to have when considering their options.

[fabfatgrl 10]

I don't regret self-paying for my Band. It was $10,000... and I've spent maybe $4000 so far in fill costs. That sounds a lot, I know... but realistically, I've spent just as much on spas, diet doctors, infomerical wonder diets, exercise equipment, and personal trainers... and never achieved the success I did with my Band, even with all of its faults. Yeah, my Band crapped out on me after my first pregnancy (18 or so months after Banding)... but I had never lost 95 pounds before. It's been four years and three pregnancies since the mega unfill (I'm not counting fills since that I haven't been able to keep for more than a day)... and I'm keeping off 50 of the 95 pounds. Prior to the Band, the most I lost was 20 or so pounds by living at a vegan health spa for a month. Needless to say, I regained it all plus some within two weeks of entering the real world. :eek:

I definitely think people discount/tune out info they don't want to hear.

I also think that what risks one is willing to take... be they operative risks, long-term risks, or even financial risks... change over time. I'm glad that the Band was my first WLS experience. It is the easiest surgery to revise. Everythign is still in tact. Had I gone with a VBG (although most surgeons had stopped doing them at the time) or even an RNY... and was facing a revision, there would be a lot more risk and expense involved.

[want2beme 2]

Wow, this is scary! I was banded 8 days ago! I want a refund! Haha, just kidding... I too read a lot about the stats and understood and understand the risks of this surgery. It is not created to make you lose all you excess weight and then you look like Pam Anderson! Going into this, I knew that I had to diet and exercise along with the band to guarantee weighloss.

In addition, I did a lot of research on erosion and slippage, etc. There are precautions you can take to decrease these risks. Like the doctor said, "You have to take care of your band." And that's true. I am not relying on the band to just suck all the fat out. I hope people feel the same way.

[mandi78 3]

One thing to keep in mind is that the procedure and the product have both been improved in the last 10 years. The problems have been identified and solutions have come about for the problems....or some of them anyway. I hope I don't encounter any of these problems down the road but my thinking is that, if I do, I'm sure there will be more options/solutions for weight loss/maintenance in another 5 or 10 years and I will try something else. But, for now, I have to do this or I may not even be around another 10 years or if I am, my quality of life in the meantime will be horrible.

And, please don't think I'm flaming you because I'm not. I think we all need to be aware of the possible complications and failures. Just because we have a band, are getting a band or want a band does not mean that we don't need to know EVERYTHING, good and bad. No, we don't WANT to hear it but we need to. Thanks for posting.

[fabfatgrl 10]

You're right, Mandi, about the product being improved. I really don't know how the new AP and VG bands will do compared to the older Bands. Surgery technique has been the same since 2001... at least with regards to what my surgeon was doing. The Band rules are still the same. It will be interesting to see if long-term studies do come out showing improved results from the new Bands.

[mandi78 3]

What I meant by the procedure having improved is modifications that have been made. For instance, correct me if I'm wrong, but I don't believe they used to stitch the top and bottom portions of the stomach together around the band but they do now to prevent slippage.

[katmeg99 0]

Thank you very much for this post. I'm due to be banded on Sept. 18 and have been trying hard to find articles about complaints/tests/long terms effects, etc. of this procedure and have had difficulty. I really appreciate the information.

One thing: it said the study years ended in 2003. Is there a more recent study out there or have things not changed much since 2003?

Again, thanks for the post.

[Kat817 19]

I was busy forming my reply in my head when I read Mandi's post---and she said it for me!!!

Yes the results of this study, several years old, are still studying the first lap bands installed (???right word????). The fact with ANY surgical procedure is that the first ones teach them things...how we respond today will help them with how they band people next year or the year after.

We had the benefit of their failures, to help our surgeons develop new techniques to reduce the complications cited.

I have no doubt they still exist. But we have no idea what post op plan these patients were given in 2003. We have no idea if they were warned of the vomiting issues.

Years ago they developed a band, and it was not adjustable. People lost weight well, but when they lost to a point of no restriction, they began regaining weight. That band, led them to develop the adjustable band. The failure rate of it was high---but look where it led us!

One of the MAJOR advantages of the band, is our ability to move on to other different surgeries, if there is a safer, better surgery found.

This is in no way meant to flame, not at all, I just wanted to try to keep in mind when the study was done, and how we are benefitting from the study as we speak!

Kat

[fabfatgrl 10]

The technique you're referring to, pars flaccida, was in common use in 2001. So... at least a good portion of the patients in the first study would have had that technique used on them.

The second study specifically states that all of the patients had the pars flaccidea technique.

Remember guys, even though the Band was approved in the US in June 2001, it was in use in Europe and Australia for 7 or 8 years before then. (Yes, both the Lap-Band and the Swedish Bands... both were adjusted via ports using saline or contrast solution.)

As for post-op plans in 2003... I can tell you that post-op instructions were the same in 2001 as they are now. We knew to avoid aggressive fills due to slippage. We knew how to manage PBs, etc. Post-op diet instructions were the same. Nothing has changed in that regard.

[ghbandster 0]

I haven't gotten my band yet but I hope to. We all are different, everyone don't react the same to the same things. Some it will work for others it won't. There are exceptions to every rule. How many times have we been told to try a product because this one, that one and the other one tried it and lost weight but it didin't work for us. For those who that happened to you were the exception to the rule. I'm glad you posted that, it's a good help for my research.

[circa 0]

Its good to read this. Things need to be stated realistically. There is no magic pill, there is no magic band. And if I hear that stupid commercial "EAT ALL YOU WANT AND STILL LOSE WEIGHT! WE COULDN'T SAY IT ON TV IF IT WASN'T TRUE!!!" Commercial again, I'm going to put my dumbells through the tv! Sure you can eat all you want and still lose weight - if you throw it up afterwards - then you end up ripping your esophagus out from the inside and dying....But anyway. Nothing is 100%. Its just like the stop smoking aids - if you smoke and want to quit and you know someone that's quit by using a product, you're going to try it, aren't you? Even if you know someone that hadn't quit smoking using it. It boils down to the individual at that point and time. The band is a GOOD thing for those that are ready for it. Just like anything else - its a hand up, not a hand out. Its a tool. A hammer is a tool - if you have a hammer and want to build a house, its not going to happen unless you use the hammer the way its supposed to be used. Just setting the hammer down on a pile of 2X4's and saying "Okay, let's build a house" and then sitting back in the rocking chair and sucking down shakes and hohos is not going to make it happen!

[vinesqueen 2]

I, of course, have to wonder how many of the people in the "failed" catagory have endrcrine problems, such as Cushing's....

It doesn't matter how much I eat, or don't eat for that matter. Calories have nothing to do with those of us with Cushing's, they seem to be irrelevent. The Band will never help us unless and until we get our endocine issues resolved.

I would so love it if an endocrine screaning was part of the pre-band work-up. I think it would save not only heart ache over not being able to lose weight with the band, but save lives too.

Strength and Courage