Lap band erosion

[Elisabethsew 50]

Now that many banded people are 2-3 years post-op, it seems like we're hearing many more stories of "band gone bad" for one reason or another.

I never found anything near the restriction I was supposed to get. Yes, I have always had a very, very, tiny amount but nothing that would restrict the amount of food I ate. Instead, I have had increasing heartburn and reguritation that require nexium.

Banding was the promise of great things when I made the decision to have surgery over 3 years ago. Since that time, studies have been released that shows the band is falling short for mnay patients and complications are on the rise. Some countries have stopped performing this procedure.

I have a male friend who did great with the band and continues to be fine and at goal. I am very happy for him and the many other patients who love the band. They found what worked for them. I know the band did not work for me even though I followed all the rules. I now feel the band is working against me. For that reason, I'll be revising to a sleeve on 4/1 and I can't wait. In the end we all want the same thing... getting to a healthy weight and leading a full life.

[DrWatkins 5]

An important consideration on the topic of reflux symptoms after band surgery is the hiatal hernia.

What we now know after doing nearly 5,000 band procedures over the past 7 years is that in essence every patient has a hiatal hernia (even if small) and needs to be repaired in every case - reinforce the hiatus with suture. This also mobilizes an intra-abdominal section of esophagus which is a very important anatomical consideration for an anti-reflux mechanism.

More and more, band surgeons are now realizing the importance of hiatal hernias and fixing them at the time of surgery to prevent problems with increasing heartburn with band fills.

Of course reflux/heartburn can also come from a dilated pouch, keeping the band too tight, eating too much or eating "plugging" foods such as bread, sticky rice, raw vegetables, microwaved Pasta, restaurant scrambled eggs or calamari (doughy, fibrousy or rubbery foods).

Before I started fixing hiatal hernias routinely in every case, I would see patients that would get heartburn when we tightened the band. This caused frustration and poor weight loss. We don't see this scenario now that we reinforce the hiatus in every case. Fixing hiatal hernias has also improved the "sweet spot" of the band and reduced dilated pouches significantly.

Unfortunately, many band surgeons do not believe the hiatus is that important and there are many band surgeons out there that are ignoring important hiatal hernias at the time of surgery and this causes frustrated patients and poor weight loss.

I have a lot of patients transfer their care to my practice and many of them have no sweet spot and lots of heartburn. Some of them have agreed to a hiatal hernia repair and this always creates a better sweet spot and the ability to tighten the band without reflux.

Any band patient having significant heartburn should have an esophogram to rule out a dilated pouch and if the esophogram is normal consideration should be given to the hiatus.

Hope that helps

brad

[Elisabethsew 50]

I am 3 years post-op and can't speak to whether or not my surgeon is now following your standards. I do know I had a small hiatal hernia on the EGD report and that it was not repaired during surgery.

I think it's very important for patients to be proactive and make sure this issue is addressed at the time of surgery. It would be interesting to see post-op comparisons of patients who did have the hiatus strengthened with those who did not.

[jms462001 9]

My Dr. always looks for and removes hernias at the time of surgery. I did not have any, but so many of his patients do. It seems like so many of the people who have problems after a few years out never had good restriction. I am wondering if the changes, "improvements" in the lapband, that were made in early 2008, may help prevent many of these erosion problems and other problems that occur after a few years. I know I have had good restriction and no problems thus far and sure hope it continues. I feel bad for those who have gone through the procedure and now have all these problems. I surely do not want an invasive surgery such as the sleeve or GP due to the band failing.

[WASaBubbleButt 41]

An important consideration on the topic of reflux symptoms after band surgery is the hiatal hernia.

What we now know after doing nearly 5,000 band procedures over the past 7 years is that in essence every patient has a hiatal hernia (even if small) and needs to be repaired in every case - reinforce the hiatus with suture. This also mobilizes an intra-abdominal section of esophagus which is a very important anatomical consideration for an anti-reflux mechanism.

More and more, band surgeons are now realizing the importance of hiatal hernias and fixing them at the time of surgery to prevent problems with increasing heartburn with band fills.

Of course reflux/heartburn can also come from a dilated pouch, keeping the band too tight, eating too much or eating "plugging" foods such as bread, sticky rice, raw vegetables, microwaved Pasta, restaurant scrambled eggs or calamari (doughy, fibrousy or rubbery foods).

Before I started fixing hiatal hernias routinely in every case, I would see patients that would get heartburn when we tightened the band. This caused frustration and poor weight loss. We don't see this scenario now that we reinforce the hiatus in every case. Fixing hiatal hernias has also improved the "sweet spot" of the band and reduced dilated pouches significantly.

Unfortunately, many band surgeons do not believe the hiatus is that important and there are many band surgeons out there that are ignoring important hiatal hernias at the time of surgery and this causes frustrated patients and poor weight loss.

I have a lot of patients transfer their care to my practice and many of them have no sweet spot and lots of heartburn. Some of them have agreed to a hiatal hernia repair and this always creates a better sweet spot and the ability to tighten the band without reflux.

Any band patient having significant heartburn should have an esophogram to rule out a dilated pouch and if the esophogram is normal consideration should be given to the hiatus.

Hope that helps

brad

My surgeon (in Mexico) and I discussed this at length before my band and he explained that it is well known that Hiatal hernias cause all kinds of problems with banding. He has always repaired them with all WLS types. I had one and he did repair it at the time of my band. When I had mega band problems and was on liquids the last four months of banding I revised to a sleeve. I've seen the CD of the surgery and there was no hernia as it was repaired during banding yet I experienced the same as Elisabeth. I had no reflux before banding, I had mega reflux with banding. It wasn't a hernia.

The band causes a lot of problems. Look at the boards, people have problems non stop. Newbies love the band, actually it goes like this from my experience. Those banded:

0-6 months love their band and their surgeon

6-12 months they love their band, they figured out they are the ones doing the work and not their surgeon.

12-18 months they are having problems but the scale is moving so they'll deal with it.

18-24 months they are sick of the problems and are considering their options.

24 months on they are getting revisions if they can afford it.

I'm not claiming this is a hard and fast rule, just my experience on various band boards.

I haven't had a single day since my own revision that I haven't had someone asking for help to get insurance to cover a revision. They often times can't get ins to cover due to no longer being a high BMI. Ins will pay to remove the band but not revise to another procedure type. If they don't want ins help they want help finding a procedure type for them.

I think that these band factories that doctors have created are not great. If the surgeon can only do banding and not the more complicated procedures they aren't telling people all their options such as the sleeve. They are just telling them about bands and suggesting they get bands only. That's not right... kind of unethical if you think about it.

[Elisabethsew 50]

My Dr. always looks for and removes hernias at the time of surgery. I did not have any, but so many of his patients do. It seems like so many of the people who have problems after a few years out never had good restriction. I am wondering if the changes, "improvements" in the lapband, that were made in early 2008, may help prevent many of these erosion problems and other problems that occur after a few years. I know I have had good restriction and no problems thus far and sure hope it continues. I feel bad for those who have gone through the procedure and now have all these problems. I surely do not want an invasive surgery such as the sleeve or GP due to the band failing.

Medicine is just like any other professions, you learn from past experience and make improvements. I would not want anyone to deal with the heartburn and reflux that I experience. It really drains you and impacts negatively on your quality of life.

I truly hope being banded in 2008 afforded you an improved surgical outcome. I still on the weight loss journey to a healthier me. However, I've done the research and can't deal with the band anymore. VSG is what I should have it and it's what I will be having in less than a week. Best of luck for continued success to you.

[WASaBubbleButt 41]

It would be interesting to see post-op comparisons of patients who did have the hiatus strengthened with those who did not.

Raising hand.

As explained above mine was repaired at the time of banding, I never had a dilated pouch, dilated esophagus, or a slip. But I sure had reflux. Never had problems before banding but I did after.

I could either eat a huge quantity of food or nothing at all. It was one extreme or another depending on the day.

I hated that band.

[Elisabethsew 50]

I am feeling the same way... looking forward to moving on.

[amella 0]

An important consideration on the topic of reflux symptoms after band surgery is the hiatal hernia.

What we now know after doing nearly 5,000 band procedures over the past 7 years is that in essence every patient has a hiatal hernia (even if small) and needs to be repaired in every case - reinforce the hiatus with suture. This also mobilizes an intra-abdominal section of esophagus which is a very important anatomical consideration for an anti-reflux mechanism.

More and more, band surgeons are now realizing the importance of hiatal hernias and fixing them at the time of surgery to prevent problems with increasing heartburn with band fills.

Of course reflux/heartburn can also come from a dilated pouch, keeping the band too tight, eating too much or eating "plugging" foods such as bread, sticky rice, raw vegetables, microwaved Pasta, restaurant scrambled eggs or calamari (doughy, fibrousy or rubbery foods).

Before I started fixing hiatal hernias routinely in every case, I would see patients that would get heartburn when we tightened the band. This caused frustration and poor weight loss. We don't see this scenario now that we reinforce the hiatus in every case. Fixing hiatal hernias has also improved the "sweet spot" of the band and reduced dilated pouches significantly.

Unfortunately, many band surgeons do not believe the hiatus is that important and there are many band surgeons out there that are ignoring important hiatal hernias at the time of surgery and this causes frustrated patients and poor weight loss.

I have a lot of patients transfer their care to my practice and many of them have no sweet spot and lots of heartburn. Some of them have agreed to a hiatal hernia repair and this always creates a better sweet spot and the ability to tighten the band without reflux.

Any band patient having significant heartburn should have an esophogram to rule out a dilated pouch and if the esophogram is normal consideration should be given to the hiatus.

Hope that helps

brad

This is so true - I had a hernia that was fixed at time of surgery - I had reflux which was getting quite worse before my surgery but since my surgery I have had no reflux at all no matter what I eat:smile2:

[JulesMc 0]

Hi!My 1st time on this site. My lap band was place over 2 years ago, I lost 70lbs, then a year ago, I started gaining weight again. Ive gained back 25lbs! found out my band has been eroding for 1 year now. I had it done in Mexico, but I cant afford the cost for removal, and Im not insured, so I do not know what to do to get this out! Any suggestions or links for more info? Thanks!!

[Oregondaisy 2,021]

I am having mine taken out by Dr. Aceves. I can't wait. I am really afraid that even though I am not having problems at the moment, it's just a matter of time until I do. I am gaining weight too, because my band is pretty much empty to avoid the reflux I was having.

Dr. Aceves is a wonderful doctor and I am sure you can use one of their credit options they have available to get that out before it does more damage to your stomach.

[WASaBubbleButt 41]

Hi!My 1st time on this site. My lap band was place over 2 years ago, I lost 70lbs, then a year ago, I started gaining weight again. Ive gained back 25lbs! found out my band has been eroding for 1 year now. I had it done in Mexico, but I cant afford the cost for removal, and Im not insured, so I do not know what to do to get this out! Any suggestions or links for more info? Thanks!!

A friend of mine had surgery in Tijuana 2-3 years ago and she had a severe erosion, I don't know if all eroded bands cost the same but hers was $5K by Dr. Aceves. Like I wrote, I don't know if that is a standard price or not. Rumbaut and Zapata are also great choices in safe locations as well.

[JulesMc 0]

Hi & thanks for replying!!I will check out that dr.!!

[Kat225 2]

Raising hand.

I could either eat a huge quantity of food or nothing at all. It was one extreme or another depending on the day.

I hated that band.

I've been experiencing the same problem. Just when I think I must be too tight and I must need to go get an unfill, I can eat a large meal. Of course I eat it because I never know when I will get another chance to eat again. The next day, I will be on liquids. What was the issue with your band that the same thing happened to you? Did you find out what the problem was? What do you suggest I do?

[WASaBubbleButt 41]

I've been experiencing the same problem. Just when I think I must be too tight and I must need to go get an unfill, I can eat a large meal. Of course I eat it because I never know when I will get another chance to eat again. The next day, I will be on liquids. What was the issue with your band that the same thing happened to you? Did you find out what the problem was? What do you suggest I do?

Ohhhh, that sounds sooo familiar! I must need an unfill because I can eat anything. Next day... I have mega restriction.

My problem was band intolerance, I hope you do not have the same.