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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It’s natural to be nervous on the day of Gastric Banding Surgery but at the same time you can be excited as it’s a milestone your journey to a healthier and happier life.

Preparing for Surgery

Before you have the surgery, your gastric banding surgeon will discuss your procedure in detail with you. It is also very important for you to discuss your overall health and your health history with him. You need to let your surgeon know if you are allergic to any drugs, have any current/past health conditions, or have ever had a bad reaction to anesthesia. In addition to this, make a list of all the medications that you take how ever small it is, including aspirin, injections, all prescription and over-the-counter drugs, herbal supplements, vitamins, and recreational drugs, and give it to your surgeon.

Your doctor/surgeon may also want you to meet with other medical experts, such as a dietitian and/or psychologist, to help you understand what will happen during and after the gastric banding surgery process. They will help you make certain that you are emotionally and mentally prepared for the up coming surgery and your new life afterwards. You will be required to have a number of tests before your surgery to evaluate your general state of health.

On the day before your gastric procedure, you will need to listen and follow the specific instructions to ensure a smooth surgery the next day. Your surgeon or medical team will provide you with a complete list of the do’s and dont’s on how to prepare for the surgery.

Here are two general guidelines:

1. Do not eat or drink anything after midnight the day before surgery this way your stomach will be empty for surgery to minimize risks during the gastric banding operation.
2. Ask a friend or a family member to be at the hospital with you for comfort and support and to drive you home after the surgery.

What to Expect on Surgery Day

The routine at your healthcare/hospital facility may be different form country to country. You will be admitted to the hospital either the day before, or on the actual morning of your surgery. You may be in the operating room for the morning but the actual procedure typically takes about one hour. Then you will spend a few hours in the recovery room. Once the anesthesia has worn off, you may feel some pain or discomfort from the operation which can usually be treated with pain killers.

On the day after the surgery, you will likely have an X-ray. This allows your health team to see that the gastric banding System is in the right place and that the new stomach outlet is open. You may be asked to swallow a liquid that can be seen on X-ray.

Typically for gastric banding surgery, hospitalization is usually less than 24 hours. However the hospital stay may have you stay longer if there are complications or if the surgeon has to change to an “open” surgical procedure.

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After you have completed your gastric banding surgery your band will be empty up to 6 weeks to allow the surgery to heal and the band to adhere firmly to the stomach. After this time they will start to adjusting your gastric banding. Some people will lose weight during the first 6 weeks and others wont but don’t worry either way.

Fills or adjusting your gastric banding are painless and take just a few minutes to perform. Some people are actually able to make it to their goal weight with no adjustments but they far and few. Most patients require 3 to 5 adjustments before they are losing weight at an expected pace. So again don’t worry if you require 6 adjustments to get it right. Gastric banding is unique for this reason that we can adjust the band to our requirements against other surgeries wheres there is no option.

How are the adjustments performed?
The area on top of the port is cleaned with betadine and then lidocaine is injected into the skin using a small needle to numb the skin. After this a larger needle is then placed through the skin and into the port. Fluid is then injected into the port at amounts decided on by the surgeon.

How Do I Know If I Need An Adjustment?
You will know if your weight loss is not averaging 1-2 pounds a week. We all want immediate results now but gastric banding doesn’t work in this way. Graph out your weight loss so you can actually chart your weight on a weekly basis, but don’t weigh yourself more than once a week. Remember they are just numbers, guidelines of how you are doing but not definitive of success.

Rules for Adjustments
No matter how much fluid you have in your band there are only three kinds of fills, too little, too much and just right, the actual number of cc’s is totally irrelevant.

If you are following the rules stated below and still are feeling very hungry or not losing weight, perhaps it is time to consult your surgeon for an adjustment.

Are you drinking a minimum of 2 liters of water per day?
Actually the recommendation is to take your body weight, divide in half and that is how many ounces of water you need to drink per day to keep your cells flushed and everything in working order.  Please remember to stop drinking liquids 30 minutes prior to a meal and no drinking during the meal as you will wash food though the gastric band and end up eating more than you should.

Are you engaging in some type of exercise or physical activity on a daily basis?
Raking your yard, walking your dog, weeding the garden all count as do walking to shops instead of driving.  Swimming is also a great form of physical activity for those with joint problems, and it is something one can do with children or families. Exercise after gastric surgery is important and is cumulative and it all adds up so every little bit counts!

Are you eating 60 grams of protein per day?
60 grams is not so much really, that’s approx 3 ounces servings each meal what works out to be around 21 grams of chicken. Protein is an essential building block for tissues and cells and protein helps turn off hunger and carbohydrates seem to turn it on. Try fitday they will help you track your diet. You may want look at healthy eating after gastric banding surgery.

Now you have greater understanding on Adjusting your Gastric Banding.

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If your obese and are looking to lose weight and have tried diet and exercise then Restrictive surgery could be the answer. In a restrictive surgery e.g. gastric banding for weight loss. The surgeon uses one of a variety of techniques to reduce the size of the stomach. After restrictive surgery a person feels full faster, eats less, and hence will lose weight.

The full names for the two types of restrictive surgery for weight loss are:

• Laparoscopic adjustable gastric banding which id the most common form of restrictive surgery, and
• Vertical banded gastroplasty

Laparoscopic Adjustable Gastric Banding

Laparoscopic gastric banding is often called gastric banding or lap banding and is the second most common weight loss surgery, after gastric bypass.

Gastric Lap band surgery will involves the following:

• Using laparoscopic tools, the procedure will place an adjustable silicone band around the upper part of the stomach.
• Squeezed by this silicone gastric band, the stomach becomes a pouch with about an inch-wide outlet. After banding, the stomach can only hold about an ounce of food, so you will feel full a lot faster.
• A plastic tube runs from the silicone gastric band to a circular device just under the skin. Saline (sterile salt water) can be injected or removed through the skin, flowing into or out of the silicone band.
• By adding the saline the band can be tightened or loosened as needed.

Laparoscopic adjustable gastric banding can help to reduce your weight by about 40%  on average. So someone who is 200 pounds overweight could expect to lose an average of 80 pounds after gastric banding. However, these results vary widely depending on the person.

Gastric banding for weight loss

Gastric banding for weight loss is considered the least invasive form of weight loss surgery and is also the safest too. The procedure can be reversed if necessary and the stomach generally returns to its normal size.

Gastric lap banding surgery has a low complication rate. The most common problems after lap banding surgery include:

• Nausea and vomiting. Can by reduced by adjustment of the banding.
• Minor surgical complications occur less than 10% of the time. These include problems with the adjustment device, wound infections, or minor bleeding.
• The risk of death due to lap banding surgery is about 1 in 2,000.

Unlike gastric bypass surgery, gastric banding does not interfere with food absorption but just the quantity of food that taken. So vitamin deficiency for people who had Gastric banding is rare.

Vertical Banded Gastroplasty (VBG)

Vertical banded gastroplasty also involves a similar plastic band placed around the stomach. In addition to the band the surgeon will staple the stomach above the band into a small pouch.

Vertical banded gastroplasty results in less weight loss, compared with other surgeries and also has a higher complication rate. Therefore due to this vertical banded gastroplasty is less common today as approx. only 5% of bariatric surgeons still perform this surgery.

Mixed Surgeries (Restrictive and Malabsorptive)

Restrictive surgery is an important part of nearly all weight loss surgeries. In the most common weight loss surgery, gastric bypass surgery, restrictive surgery is first done on the stomach. This “stomach stapling” creates a small stomach pouch.

The new stomach pouch is reconnected to a part of the small intestine further down. This leads to less food eaten (restrictive) and less food absorbed (malabsorptive).

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So consider using gastric banding for weight loss .

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Gastric banding is considered a safe form of Surgery and fro most people the benefits of weight loss out way the advantages related to the surgery, however all surgeries do carry some form of risk. Therefore for you to be able to make a well informed decision to have about Gastric Banding, you must be made aware of the possible side effects and what complications that may occur as a result of Gastric Banding Surgery.

Side-effects are an unwanted by product of the Gastric Banding Surgery but are generally temporary effects of the Surgery, afterwards you are likely to have bruising, pain and swelling around the wounds left behind from the surgery.

You may feel or be sick after eating, especially if you try to eat too much. Your restricted diet may cause some shortage of nutrients so you may consider taking multivitamin tablet as a supplement.

Complications caused from Gastric Banding occur during or after the surgery, but most people are not affected. Some possible complications of Gastric Banding Surgery include a reaction to the anaesthesia or excessive bleeding during or soon after surgery for this case a  blood transfusion may be required.

Some of the specific gastric banding complications:

* Wound infection. Antibiotics are given during surgery to help prevent this.
* For up to six weeks after the operation, it is possible to develop a blood clot (DVT) in the veins in the leg. This clot can break off and cause a blockage in the lungs. In most cases this is treatable, but it can be a life-threatening condition. Compression stockings, intermittent compression pumps and blood-thinning injections are used to help prevent DVT.
* There is a risk that during the operation other organs in the abdomen may be accidentally damaged.
* There is a risk that the gastric band may slip out of place, break or erode through the stomach wall. This may require further surgery or removal of the gastric band.
* It is possible you may fail to lose sufficient weight or regain weight, and some patients have further weight loss surgery.
* If you lose weight rapidly, there is a risk of developing gallstones in your gallbladder. These can be painful. Your surgeon may remove your gallbladder during surgery.

Before any surgery you should ask your surgeon to explain how these risks apply to you. The exact risks will differ for every person.

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What is Gastric Banding?

So what is Gastric Banding?

Gastric banding is a surgical procedure that involves fitting a band around the upper part of your stomach, which will only be recommended as a fnal resort for people who are morbidly obese i.e. people with a BMI of over 40.

Gastric Banding can also be given if others that have a serious health risk, such as diabetes, high blood pressure (hypertension), or heart disease and a BMI of between 30 to 40.

If you are very obese, gastric banding Surgery can be used as a way of helping you to lose weight by controlling the amount of food that you eat.

How does gastric banding work?

Once you have completed the surgery, the gastric band can be adjusted outside the body at any time by a surgeon. This means the gastric band can be adjusted tighter or looser, depending on the amount of food your surgeon wants to restrict you from eating.

Your surgeon can adjust the gastric band tighter by simply adding salt water (saline) into the band. This will slow down the amount of food that can pass through your stomach – meaning your will feel full longer. The opposite direction is to loosen the band, some of the salt water fluid is removed and allows food to pass through quicker to your digestive system. Generally, a gastric band is loose to start and then tightened when you are used to eating less food.

A gastric banding is designed to remain permanently within your stomach, but it can be removed, and in the majority of cases leaves you with no permanent changes to your stomach once removed. The Gastric Banding procedure involves a certain degree of complication, for example there is a risk of infection, and in rare cases, leaking into your stomach may occur.

Hope this helps explain clearly what is gastric banding.

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