Lap BandTM Complications
Lap BandTM (or gastric band) surgery can cause many long-term complications. These complications often lead to gastric band removal. Unfortunately, unlike other bariatric surgical procedures, Lap BandTM surgery introduces a foreign body to your stomach. Because of this, the risk of complications increases over time; one study found that each year after surgery adds a 3-4% increase to the complication rate. Long-term, over one-third of patients experience at least one complication.
Numerous studies find that many gastric band patients will experience the following complications, most of which are unique to the band:
- Band erosion
- Band intolerance
- Band Infection
- Band slippage
- Esophageal dilation
- Food trapping
- Pouch dilation
- Ineffective weight loss
- Band or port leak
- Port problems
Because of the very real health concerns associated with gastric band surgery, we no longer offer this surgery at the BMCC. If you’re looking for bariatric surgery or are struggling with long-term complications of a lap band, please go ahead and contact us and we’ll be happy to recommend a safer, more effective solution.
You can learn more about each of the above Lap BandTM complications, and how common they are, below:
Band Erosion (occurs in 2-9% of patients)
This Lap BandTM side effect occurs when the band erodes through the outer stomach wall right into the inside portion of the stomach. This makes the procedure less effective: patients often find themselves feeling hungrier, because the Band doesn’t restrict the size of the stomach as well. Band erosion can also cause progressive infection in some cases, which can be life threatening.
Band Intolerance (at least 6.9% of patients)
Because the band is a foreign object, your body may not respond well to it. Your body might develop excessive scar tissue. Band intolerance can result in progressive nausea, vomiting and reflux that may not permit fills. Even worse, these symptoms may not improve when the fill fluid is removed. In these cases, the only solution is band removal.
Port or Band Infection (1-4% of patients)
Because the band hardware is a foreign body, there will always be a small chance of the port or band becoming infected. An infection often requires band and port removal.
Band Slippage (1-22% of patients)
This Lap BandTM complication can produce vomiting and acid reflux. It is caused when the band slips out of the correct place, usually downward on the stomach. Although good surgical technique can reduce the slip risk somewhat, this risk can never be fully eliminated. Even when the slip is corrected, over half of patients experience recurrence. Often, this requires band removal to fix this problem.
Esophageal Dilation (up to 14% of patients)
Esophageal dilation is an enlarging of the esophagus, which can occur 5-7 years after your band has been placed. As the esophagus dilates it begins to lose its normal function of pushing food downward toward the stomach. At the same time, the valve between the esophagus and the stomach can become less effective. This can lead to difficulty swallowing, vomiting, and worsening heartburn (or acid reflux).
Food Trapping (around 2% of patients)
This Lap BandTM complication occurs because, even in the absence of a band slip, pieces of food can be still be caught in the narrowed stomach opening constricted by the band and scar tissue. This gastric band problem can be caused by eating inappropriate foods or not chewing well. However, it can also be caused by sudden altitude changes, which cause the stomach to swell and makes the band too tight.
It can also be caused by a buildup of scar tissue, which can be some peoples’ responses to the introduction of a foreign body (the Lap BandTM). Patients often have to vomit the stuck food back up. In some cases, you may not be able to tolerate eating or drinking again until fluid is removed from your band.
Pouch Dilation (4-9% of patients)
The stomach can sometimes stretch above the band, which makes the band less effective. This This Lap BandTM complication makes your stomach effectively larger, leading to out-of-control hunger that can cause weight regain.
Band or Port Leak (Hardware Failure in 1-4% of patients)
Sometimes the inner balloon portion of the band or the tubing near the port can break down and leak the fill fluid. This means that your band can no longer hold its fill volumes. This loosens the band, meaning that it can’t constrict your stomach. This Lap BandTM problem can leave you feeling hungrier and can ultimately lead to weight regain.
A band balloon leak can be diagnosed by injecting contrast fluid into the band, which will show up on X-ray. Your doctor will then take an X-ray to see if this fluid is present outside of the gastric banding system. A band or port leak can only be corrected surgically, and there is no guarantee that it will not reoccur in the future.
Port Problems (up to 20% of patients)
Port Flip or Inversion: The anchors of the port used to fill the gastric band can come loose, allowing the port to physically flip on its side or even upside down. This can make it difficult or impossible for your doctor to access this port for band fills and unfills. This gastric band complication often requires a surgical procedure to revise the port and its anchor system.
Unfortunately, these gastric band problems are not rare. In most cases they are also not preventable once a band has been placed. A number of international studies show that 25-50% of Lap Bands need to be removed in the first 5 years alone, due to complications. There is no way to tell ahead of time which patients will suffer from band failure, and because of these issues we have decided not to offer this procedure at the BMCC.
And, unfortunately, these are not the only side effects of Lap BandTM surgery.
Other Lap BandTM Risks
In addition to the complications above, Lap BandTM patients may face other risks both during and after surgery. If you’re considering surgery, you should be aware of the following Lap BandTM risks:
- Band prolapse
- Stomach necrosis
- Difficulty swallowing
- Bowel perforations
- Nausea and vomiting
You can learn more about each of these Lap BandTM problems below:
Gastro-esophageal reflux disease (GERD) can occur or become more severe following the placement of a band. This can happen because the band creates a restrictive point that increases upper stomach pressures. If the lower esophageal sphincter (which normally prevents acid from coming back up from the stomach) is already weak or is weakened (as a side effect of Lap BandTM surgery), reflux can increase. This symptom becomes more likely over time, and it can lead some patients to develop esophageal damage from the gastric acid. This can require Lap BandTM removal.
A piece of the bottom portion of the stomach can prolapse (slip) upward through the band. This can be dangerous if blood supply to this portion of the stomach becomes compromised as a result.
Sometimes the vascular supply to the stomach can become twisted or compromised by the band. This can lead to this part of the stomach actually dying because it cannot receive any fluids from the rest of the body. This is a very serious Lap BandTM risk: patients can become critically ill and need emergency surgery.
This is a common but fairly minor Lap BandTM risk for most patients. You can become constipated as a result of not drinking enough water throughout the day. For most patients this is easily treated by improving hydration and sometimes adding stool softeners or fiber supplements.
Because the Lap BandTM restricts food intake at the upper portion of the stomach after surgery, you won’t be able to eat as much or as quickly. Patients who try to eat too fast, or without chewing enough, can experience difficulty swallowing (called dysphagia). Sometimes, this symptom can indicate that the band is too tight (very common after changes in altitude). In this setting, dysphagia can be relieved by your doctor removing some fluid from the band.
However, patients can also experience difficulty swallowing because of a buildup of scar tissue. Scar tissue will always form in response to the foreign body (band). In some patients, over time this scar tissue can become excessive or constrict tightly around the stomach. When this happens, removing fluid may not improve symptoms.
This Lap BandTM side effect can occur due to an inadvertent bowel or stomach injury during surgery. It can also be due to the band eroding into or strangulating the stomach or another piece of intestine. If this happens, it may become a surgical emergency requiring emergent repair.
Nausea and Vomiting
Gastric band patients often report nausea and vomiting after surgery. One study found that patients feel nauseous an average of 1.4 times per week and vomited once a week.
Some people say that Lap BandTM risks and complications can be handled with better surgery. Here’s the problem with that:
Handling Lap BandTM Complications
Some people defend the Lap Band, and argue that it’s a safe, effective tool that’s less invasive than other bariatric surgeries. Let’s look at some of reasons given to support Lap BandTM surgery below, and we’ll explain why the Lap BandTM is still not an effective weight loss tool.
Improved Surgical Technique
Some believe that using certain techniques (see below for details) can reduce Lap BandTM complications and make this procedure safe and effective. However, the data above include these modified techniques. Because of this, at the BMCC we believe that the risks of gastric band surgery outweigh the benefits—even when using these techniques.
Some of the techniques that have been used in an attempt to reduce Lap BandTM complications include the pars flaccida technique (pft) and band plication technique. These were developed to minimize band slip rates, but slip rates remain high even when using these methods. Additionally, these methods do not effectively address many of the other Lap BandTM risks.
Ineffective Weight Loss (at least 25-43% of patients) and Weight Regain
One of the key Lap BandTM problems that surgical techniques have not been able to address is weight regain. Gastric band surgery typically results in less weight loss than other bariatric procedures, and patients are more likely to experience weight regain. One large study found that patients who kept their band for 14 years experienced significant weight regain. Over this time period, their average durable weight loss was only 15% of their unhealthy body weight. A majority of patients are not able to sustain their weight loss after this surgery.
Additionally, many patients see less than the reported initial average weight loss of 35-50% of their unhealthy body weight. This is much less effective and less durable than other surgical options, and many patients do not achieve even this level of weight loss.
Some believe that regular follow-up can alleviate this problem. Dr. Paul O’Brien, who published a study supporting the Lap BandTM, says, “Compliance and follow-up are critically important. There are plenty of people out there doing this surgery without a follow-up program for their patients, and they are setting them up for failure.”
It’s true that, in every kind of bariatric surgery, routine follow-up after surgery is critical. Patients who regularly check in with their surgeon and dietician lose more weight and have better long-term outcomes than those who do not.
However, even with regular follow-up, the Lap BandTM is an inefficient weight loss solution. The weight loss numbers cited above include both patients who follow up, and those who do not. By contrast, with the gastric bypass, patients generally lose 65-90% of their excess weight. While following up with your doctor is crucial, this is not enough to make the Lap BandTM a viable surgery.
Evolution of Lap Band Surgery
Some argue that, while the Lap BandTM surgery used to be unsafe and ineffective, new advancements have made the gastric band surgery more viable. For instance, one of the biggest studies criticizing the band looked at patients who had the surgery between 1994 and 1997. While the results were concerning, surgeons pointed out that the study critiqued a process that was argued in 2011 that, “unfortunately, I don’t think the outcome (of newer Lap Band procedures) is that much better.” While most bariatric procedures have become more effective, the Lap Band continues to lag behind.
Is the Lap Band Less Invasive?
Many defenders of the Lap Band argue that it’s less invasive than competing surgeries, because it doesn’t involve permanent changes to the stomach and can be reversed. However, about half of Lap Band patients need additional surgeries in order to either deal with complications, or adjust the band. Many require Lap Band removal, and in order to have effective weight loss they require revision to a different surgery.
Because of this, it’s a mistake to consider the Lap Band less invasive, just because it can be reversed. The prevalence of Lap Band complications requiring additional surgery clearly shows that this procedure and the resulting need for revisions can be highly invasive.
The Lap BandTM fundamentally carries higher long-term risk and is less effective than other bariatric surgical procedures.
Having Lap BandTM Complications?
If you already had band surgery and are experiencing complications, then the most effective solution may be band removal and revision to a more effective bariatric surgery. This can help with symptoms such as increased hunger and weight regain, pain, and nausea and vomiting.
Safer, More Effective Bariatric Surgeries
If you were considering Lap BandTM surgery, we understand that it can be difficult to struggle again and again with ineffective weight loss methods. This is exactly why we do not offer the Lap BandTM.
We have many other bariatric surgical options that are far more effective and less risky over time. Many of our patients were originally interested in a gastric band until they learned about the above complications. Like them you can instead choose a more effective weight loss procedure such as a gastric bypass or sleeve gastrectomy. These patients are now very happy with their choice and their results.
If you or a loved one have further questions or would like more information about bariatric surgery or other surgical or non-surgical weight loss, please check out our FREE ONLINE SEMINAR or REGISTER FOR A LIVE SEMINAR today.
If you currently have a LAP-BAND®, please review our LAP-BAND® Fill informational card.