Do I need my band re-positioned or am I just not doing it right?

[Kaz Radford 0]

I got my band 18 monhts ago. The current trend for my surgeon was to place the band very high at the top of the stomach leaving no pouch.

Initial weight loss was good but that was when I was still going for full Meal Replacement. When I introduced solid food I found I could eat anything with no restriction and no sense of fullness.

I've had 5 fills and have been right up to 9.5 mils where I could only swallow liquids and then only after a certain time in the morning.

The last time I saw my surgeon he said I had esophageal dilatation and so have been deflated for 8 weeks.

I've just had my band filled to 5 mils and I'm pretty much where I was when it was empty.

Througout the fills and top-ups I have either been able to swallow or not. There is no in-between which is what I desire - a sense of fullness after eating a small portion or at least some sense of slowing down of the food process.

He's offered to re-position the band for me.

Has anyone else had this issue?

I'm worried that if I have the band re-positioned I won't be any further ahead than I am now and although money isn't everything it would be nice to have some kind of indication that I could achieve the same sensations that my friends who also have bands talk about.

Any advice gratefully received:unsure:

[Jachut 487]

There's never been a "trend" to place the band high and leave no pouch, if its been placed like that, them its been misplaced.

The band is designed to work with a pouch and to be placed at a point on the stomach where restriction will be possible. If yours is high, when you get it very tight, your esophagus is going to be become your pouch.

This must be very distressing for you, but it has to be looked at. You're never going to get it working if its not placed right. But personally, I'd be seeking a second opinion from another surgeon.

[Kaz Radford 0]

Thanks Jaqui, I had had that thought. Logic tells me that there needs to be a pouch.

[greenfrog 0]

Hello, I have just found this site and have just posted a thread around the same thing as yourself. Although I did start with a pouch the band slipped upwards and the rest of my experience is the same as yours.

Did you get a second opinion. If so I would be really pleased to hear about it?

Greenfrog.

[Band_Groupie 3]

Ditto the second opinion...where does he tell you the food will sit while it's providing that 'full' feeling for hours (which is why we got the band) before it goes through the stoma?!! The only place that's left is your esophagus. Sounds like you need a new surgeon. Best wishes! -BG

[1SkinnyChick 0]

This thread was perfect timing for me. Thanks to the starter and the responders.

I have a concern that my band is placed too high as well. Fortunately, I do not have any issues swallowing. I can eat as much and anything I choose.

I went for my first fill friday, 1/15/10, 4 days ago and the doc performs this under fluoro.

The nurse went to position the machine where it should be, stomach area and the band was not visible.

The doctor told her to move it up just a bit, that my band was "up a little higher, but still in a good place". This was said before the machine was even lifted. How did he know it was in a good place?!

The nurse moved the machine higher to what I believed was still a somewhat reasonable place and they still did not see the band.

Finally the doctor moved the machine up very high and had me turn slightly at the waist and they were able to see the band.

At my pre-op I'd asked the doctor why I felt something (didn't know what) other than the port this high up on my stomach. He assured me it was my port and probably swelling. (this was 24 days post-op). I knew then it was my band.

I got the fill, 3ccs, which after doing the barium swallow the doctor said the band would be very tight. It is not tight at all. I feel no fullness.

I really don't know what my next step should be.

Should I just try to get another fill and see how it goes or should I raise hell now?

[adagray 1]

Its definitely time for a second opinion. I'm certainly no doctor or lawyer, but it seems like the esophageal dilatation was caused by the band being placed too high in the first place and you deserve damages for all this has put you through in the last 18 months. Personally, I would not go back to the same surgeon after I suspect he has been negligent or, worse, used me as a guinea pig to test out his own theory.

Was your initial lapband placement covered by insurance? If so, you should be able to see a different surgeon and get the ball rolling w/investigating the problem and fixing things right away. Not all surgeons will take on revision surgeries, but generally, the best of the best will and they take pride in being able to fix problem cases.

If you are self-pay, its a bit more tricky because then you probably need this settled in order to have the money to proceed w/revision surgery. But, still, I would not be tempted by your original surgeon's promise that he can fix this for free. You don't want him messing you up so badly that another surgeon can't fix it. Even though I'm sure its heartbreaking to put the weightloss on hold, I would unfill the band if you have to in order to get your settlement first if necessary.

Best wishes to you and I'm so sorry you have to go trough this.

[greenfrog 0]

Hi Everyone (especially 1SkinnyChick). I have just been discharged from hospital this evening having had a revision of gastric band via laparotomy and feeling very good considering. A few people contacted me about their experiences and opinions about my problem with having a band which moved upwards sitting on the oesphagus and the build up of lesions which meant the band could not be repositioned using key hole surgery. The outcome being I decided to have the laparotomy (the big scar from below bra line to above belly button) and take the risk associated with having the band repositioned. The surgeon reluctantly did it free of charge. The reason why I decided not to live with the band situated at the base of the oesophagus and by adjusting fills as and when, were as follows:

1) I'd paid for an op that never happened. The surgeon fobbed me off for many months which lead to the build up of the lesions, so I suppose I was a bit angry with him for causing the problem. My advice here is don't delay, every week means the lesions build up and make any revision / replacement op more of a risk and less likely to succeed.

2) Many people in our position said their surgeons had discouraged repositioning (probably for their own reasons) and encouraged them to find a fill 'sweet-spot'. So they could live with a restriction and continue to lose weight. From what I was told this weight loss would be temporary (and with me it was). We learn to eat around the band. I for example do not like chocolate but as it is easy to get hold of I found I was eating more of this as I was hungry and its convenient and didn't block. Hence my weight rose.

3) I found that the only way I could manage my weight with the band high was a method of eating foods which got stuck (I had 7mls fill therefore a mouth full of bread would do it) this then caused pain and vomitting to release the blockage. This was becoming awkward, not very healthy in the long term, and was getting me down.

4) Over the past 8 months since I had the band fitted my appetite has never changed. This is why I wanted a band in first place...that feeling of being full.

The surgeon was pessimistic about the success of the op, harping on about risk to liver, spleen and high probability that it would not be successful, I felt he was trying to dissuade me so I decided to trust my instinct and go ahead. I had a revision via laparotomy on Monday. He could not reposition the exiting band due to need to cut away the lesions to gain access, so he removed it and put a new one in. He said it was easier than expected. I definitely ruled out a gastric by-pass. I am still very causion that it may slip again but for some reason I think the surgoen may have done a better job this time, so it wont, but I am taking no chances. Today for the first time I felt what they called a restriction. I had a scoop of sorbet and 100mls of Soup and I was genuinely full.

My feeling is don't delay. I let my surgeon 'delay', by the time I went to have it repositioned via key hole surgery it was too late, the lesions were too established, hence I needed the big op. I may at least be thin but my belly daning days are over due to scars!!!! It could have been alot worse so I'm happy. Hope this helps. Off to bed now with my painkillers. Good luck Sarah.

[Band_Groupie 3]

Sarah- So glad to hear this worked! I'm curious, what were your symptoms that the band had moved up (a normal 'slip' actually makes a larger pouch so I'm trying to picture how the band moves up and you have no pouch if it's stitched in place on one side?). One more, hope you don't mind...what's a 'lesion'...is it a scar or maybe the start of an erosion? Thanks! -BG

[greenfrog 0]

Morning BG. my last narrative was a bit waffley as I had just come home from hospital so I probably didn't explain myself well. On day three post op when I first had the band fitted, and I was still on fluids and in bed, I experienced extreme pain just below my sternum. It was constant (15mins) and enough to double me over. Suddenly I felt something release and the pain went immediately. After I was then able to eat any size meal (the same as prior to the op). What had hap pended is the band positioned slightly down the stomach defining a small pouch had moved up to sit on top of the stomach, the base of the oesophagus. I'm not sure why it happened and my surgeon has not shed any light on the matter. The surgeon described the lesions as a ''cement'. Apparently when any band is fitted it is natural for the body to try and cement it in place (or reject it). Lesions were also described to me as scarring. However in my case the lesions grew prolifically, they do stop growing when the body has accepted the band and it does help to keep the band in place. However to remove any band, after a length of time, it is the lesions that cause the problem. In my case a second key hole op to move the band down into position was unsuccessful due to the work (and risk) caused by the lesions. Hence I needed a laparotomy. Hope this helps, we are not all the same but there are similarities to our journeys. Bye for now. Sarah

[Band_Groupie 3]

Sarah, Thanks so much for the explanation...it helps us all to know more (well, at least me). The lesions make perfect sense now...and yes, your doc should have acted sooner...good for you for getting this fixed! Hope you're recovering well and on your way! Best wishes! -BG