There are two types of gastric band slippage; anterior and posterior which basically refers to whether the back or front side of the stomach slips. Gastric band 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 Lap Band Slippage Rare or Common?
Unfortunately, at this time there’s not much data on the frequency (or rarity) of 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.

1. Will I be sick a lot after the gastric banding operation?
2. Will I feel hungry or deprived after the gastric banding surgery?
3. Can I eat anything in moderation?
4. Can I drink alcohol?
5. Can I go out to eat?
6. Am I allowed to have my gastric lap band opened for a special occasion?
7. Does the gastric lap band limit any physical activity?
8. Do I have to be careful with the access port just underneath my skin?

1. Will I be sick a lot after the gastric banding operation?
The gastric banding will limit the amount of food you can eat at one time. If you always feeling nauseated on a regular basis, it probably means that you aren’t chewing your food well enough or that you aren’t following the gastric banding post-surgical diet properly, other reason could be that the placement of the gastrc band have a problem, so contact your doctor if you continue to get sick. You must avoid vomiting as much as possible because it can cause your small stomach pouch to stretch. It can also lead to slippage of the band which will offsetting the effectiveness of your surgery. In some severe cases, damage due to vomiting can mean another operation.

2. Will I feel hungry or deprived after the gastric banding surgery?
The gastric lap band makes you eat less and feel full in two ways:

• By reducing how much your stomach can hold at one time
• By increasing the time it takes food to get through your digestive system.

After a small meal, the amount of which varies from person to person, you should feel full and satisfied for some time. If you follow the nutrition guidelines when you choose your food and then chew it well, you shouldn’t feel hungry or deprived at all.
3. Can I eat anything in moderation?
After your stomach has healed, generally you may eat most foods that don’t cause you discomfort. Since you can only eat a small amount of food at a time, it is important that you choose nutritious, vitamin-rich foods. You may click here to find out some problem foods after you avoid after gastric banding.

4. Can I drink alcohol?
Alcohol has a lot of calories and breaks down vitamins. An occasional glass of wine or other alcoholic beverage is not considered harmful to weight loss.

5. Can I go out to eat?
Order only a small portion, such as an appetizer and try to eat slowly. It may help if you stop eating at the same time as your dinner companions too. Best to explain to your host or hostess know in advance that you cannot eat very much.
6. Am I allowed to have my gastric lap band opened for a special occasion?
While it is tempting and easy, your gastric lap band should not be opened to eat a big meal at a special occasion. However the gastric lap band can be opened for medical reasons such as pregnancy, when you will need to increase your nutritional intake.

7. Does the gastric lap band limit any physical activity?
It should not hamper any type of physical activity. You should be free to do aerobics, stretches, and any strenuous exercise you enjoy once you’ve completely recovered.

8. Do I have to be careful with the access port just underneath my skin?
The access port is placed under the skin in the abdominal wall, it should not cause discomfort or limit any physical exercise at all. The only sensation you may experience from the port occurs when you go in for adjustments. If you feel persistent discomfort in the port area, see your doctor.

Slippage
In order for the band to function properly it must be correctly positioned on the stomach. Gastric banding can slip that is twist out of position. Typically the band does not slip but actually the stomach slips above the band. A slip typically occurs in about 2% of all operations.

Slippage can occur for a variety of reasons like over filling resulting in vomiting can be a cause. Slippage can cause reflux and difficultly with foods and weight loss can be affected. You may require a X-ray to obtain if the gastric banding has slipped. Some slippages if caught early enough can be corrected by removing all saline from the band and allowing the stomach to heal and then gradually re-filling. Slippage may require re-operation to reposition the band and in extreme cases gastric band removal. If a band is removed for slippage it generally can be replaced after a healing period.

Band Erosion
Gastric banding has been known to erode into the stomach. Erosion is a rare complication and is typically known in the older types of bands. This occurs again occurs in about 2% percent of patients. It occurs when the stomach tissue over-growing around the band until the band is on the inside of the stomach instead of the outside. Erosion will involves gastric band removal, sometimes surgical, although it rarely is a life-threatening situation.

Infection
With all surgical procedure there is always the slight risk of infection. Infections can usually be treated with antibiotics and in rare cases may necessitate removal. Always make sure you are in top health prior to your surgery or adjustments without colds or drugs that may compromise your immune system. Notify your doctor immediately if you suspect you may have an infection of any type.

Stretched Pouch
This is a complication that can be avoided by simply not overeating. Learn to stop eating the moment you feel satisfied and avoid continuous packing food into your stomach when full. As this willcause it to stretch and food may back up into your esophagus causing you future discomfort and problems.

Gastric Band Hardware Difficulties
Ports have been broken and tubing punctured usually during the filling process and this risk is reduced by using experienced practitioners and using fluoroscope to locate the port before hand. However, broken ports and punctured tubing are relatively simple matters to fix but can be frustrating for the patient. The problem has been addressed with newer port designs.

Reflux
Reflux is associated with a too tight gastric band causing stomach fluids to back up into the esophagus and damage the delicate tissues not strong enough to cater for acidic stomach juices. If you are experiencing mild reflux talk to your doctor about preventative measures such as diets for after gastric banding surgery or medications. If your reflux is a persistent problem speak to him immediately, don’t complicate the issue by waiting hoping it will get better without intervention.

These are the main risks related with Gastric Banding.