What is a gastric lap band slippage, and what causes it?

There are two types of gastric lap band slippage ; anterior and posterior which basically refers to whether the back or front side of the stomach slips. Gastric band lap slippage or prolapse is where the stomach slides up through the Band, making the pouch bigger. If this happens to a patient its because the Band usually becomes too tight, and patients will experience symptoms of reflux (heartburn) as well as nausea and vomiting. This is due to the amount of stomach being “squeezed” by the Gastric Band is increased, thereby obstructing the Band.

Anterior slippage is where the front of the stomach slips up though the band. We try to prevent this by suturing the stomach below the Band to the stomach above the Band, “locking” the Band in place in the right spot. In spite of this, slippage still occurs. It can happen for two reason, one because the surgeon haven’t placed enough stitches, or they haven’t been placed in the right place or secondly slippage can also occur if patients eat too much and vomits frequently.

Posterior slippage was more commonly seen when the Gastric Banding was placed by the “perigastric” technique. With this technique the back side of the stomach was free to slide up through the Band. Now a days surgeons use the “pars flaccida” technique, which was developed to prevent this form of slippage, and has more or less eliminated the incidence of this problem.

Is Gastric Lap Band Slippage Rare or Common?
Unfortunately, at this time there’s not much data on the frequency (or rarity) of gastric lap band slippage in post-surgery patients. As this surgery increases in popularity and longevity, there will certainly be more data available on the frequency of Lap Band slippage in patients,

How is a slipped Band diagnosed?

This is very easy, as diagnosis is made based on the history of the patient. A patient who has been going along fine, with no problems, and then suddenly develops reflux symptoms or symptoms of a too-tight Band will most likely have a slipped Gastric Band. The diagnosis is easily confirmed with an x-ray and barium swallow examination.

How is a slipped Band fixed?

A slipped Band needs to be fixed with another operation. The Gastric Band has to be dissected out, all the sutures removed, and the position of the stomach made right. Some surgeons remove the Band and place it back with a new one and others just straighten things out.

What happens if the Band slips again?

One could certainly try to fix the slip again by again another surgery, but my personal view is that, for whatever reason, the Band is just not working for that particular patient, and ought to be removed.

So you can see gastric lap band slippage can happen and it is solvable.

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