Lap Band Erosion
There are many terms that have become familiar to the lap band population because they are commonly used among doctors and patients. One popular term is “Lap Band” which stands for Laparoscopic Gastric Banding. The term “Lap Band Erosion” also became very popular among the banded patients as lap band message boards increased in popularity. The patients that already had the Lap Band were concerned as“erosion” was often connected to topics such as de-banding or surgical removal of the band. However, the term actually means that the stomach has developed a penetrating ulcer and has eroded (worn away) towards the balloon of the band.
How does Stomach Erosion happen in Lap Band Patients?
Intragastric band erosions have been reported at rates that vary from 3 to 10% depending on the operatory technique or surgeon´s experience, the device used and the patient’s eating behavior. There are several different and controversial theories for the cause of erosion:
- The Lap Band around the stomach gradually erodes into the stomach wall over time, and goes into the gastric lumen, as we have seen with other intrabdominal devices.
- The stomach damage done during the Lap Band procedure debilitates the layers of the stomach wall, resulting in erosion at a later time.
- The sutures were placed too deep and trespassed all the wall layers of the stomach, causing micro perforations that generate leaking, infection and later erosion.
- Events that happens inside the stomach, such as frequent vomiting, medications, ingestion of irritants as spicy or hot food, alcohol, etc. as well as a large adjustment to the band system, will produce an ulcer that penetrates toward the balloon of the band.
I believe the last theory is the most consistent and also the most frequently seen in the vast majority of patients with erosion. Other theories, such as a crease or a fold in the balloon, which may harm and erode the stomach lining, were not scientifically proven. We have seen erosion with all kinds of Lap Bands and with all kinds of balloons and find no correlation with the fold theory.
Once the erosion-ulcer is established it is not possible to cure the ulcer, not even by removing all the fluid in the band. Therefore the need to remove the band itself becomes imperative. I recommend the band be removed AS SOON AS POSSIBLE, not because this is an emergency in any way, but because there is a risk of increasing the ulcer’s size. Removing the Lap band can help to decrease the risk of complications such as infection traveling along the hose to the port and to the skin, or stomach bleeding.
How Can Lap Band Erosion be Prevented?
There are several ways to prevent erosion. The first way that I personally recommend is to avoid “large fills” to the Lap Band, in order to prevent vomiting or gastric reflux. The second way that I recommend is to protect the stomach with anti-acids frequently, especially at bed time. The third recommendation is to avoid alcohol, hot or spicy food, vinegar, soy sauce, and coffee. Talk with your Doctor about the medications you are actually taking and ask about exchanging the ones that can hurt your stomach for others with the same effect but less stomach irriation.
Arturo Rodriguez,MD
Bariatric Surgeon
http://www.thebariatric.com
Originally posted 2008-06-12 21:18:18. Republished by Blog Post Promoter
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i had the band removed due to erosion in october. what are the chances of reinstalling it and will insurance pay for it? what type of band should i get, the realize or the other, and what is the difference, if any in having one or the other since my 1st eroded 6 years after it was put in.
thanks
lois
Comment by LOIS — July 17, 2008 @ 12:07 am
Hi Lois,
Re-banding is a feasible procedure especially if the band was taken out by Laparoscopy rather than by open surgery. The percentage of having another lap band is close to 98% in experienced surgeons.
Insurance does not cover the Lap band procedure again.
I mostly use the Realize Band but the new Allergan ( Inamed) bands have a softer and bigger balloon then the old models they had and I have used them several times successfully also.
I wait at least 6 months after the Lap band has been taken out before installing a new band.
Dr. Arturo Rodriguez
http://www.thebariatric.com
http://www.bandstersforum.com
Comment by Dr. Arturo Rodriguez — July 17, 2008 @ 12:29 am
Is is possible to have the Lap Band procedure if you already have a hiatel hernia?
Comment by Ann — July 18, 2008 @ 11:42 am
Hello Ann,
Yes, it is possible to have the lap band Surgery if you have hiatal hernia because the band acts as anti-reflux procedure. (This is what you want to obtain if you have symptomatic hiatal hernia)
Your surgeon has to do an extra work on repairing the hernia at the time of the surgery.
Most of the hiatal hernias are just surgical findings because the patients do not have any complain or any symptom at all.
Comment by Dr. Arturo Rodriguez — July 18, 2008 @ 4:30 pm
Can I have my lap-band removed and get gastric bypass instead?
Thank you so much!
Comment by Angie — July 21, 2008 @ 3:38 pm
Oh, I have a slip right now in my band and all the fluid has been removed.
Before that I had already gained all my weight back and the band doesn’t seem
to work for me. That’s the reason for my inquiring about Gastric Bypass.
I would need to find a surgeon that can remove the Lap Band and perform Gastric Bypass.
Comment by Angie — July 21, 2008 @ 3:41 pm
I have just discovered by having an endoscopy my band has completely sunken into my small bowel. The photos from the endoscopy reveal large black patches in my stomach. is this an infection would you say or do you think this could be internal bleeding? I am asking this as i have been awaiting surgery to be de-banded for 2weeks as my surgeon is on leave, i am very worried as he has informed me that he has not ever had a patient to which this has happened. Thanks Jo
Comment by Jo — July 25, 2008 @ 6:51 pm
Hello,
When a bariatric procedure fails, like in your case Angie, you can have the 4 next options:
To Re-locate the same band, to re-banding you, to have an sleeve gastrectomy or to have a gastric bypass. You have to discuss your best options with your docotr before you do anything.
Jo, your case is different that “normal erosion” because your Lap band has pass through completly the stomach wall. I will say that proper evaluation by the endoscopyst and removing the band endoscopically will be your best choice saving you for a new surgical procedure, this way you will also save some money.
Comment by Dr. Arturo Rodriguez — July 25, 2008 @ 7:27 pm
Thanks. could you tell me if “normal erosion” is common and what causes the band to pass through the stomach wall and if the small bowel can repaired safely?
Comment by Jo — July 25, 2008 @ 11:48 pm
Hello Jo,
Less than 5 % of lap band patients ends up w/erosion.
When a band is at the small bowell means that the hose or tube is in the stomach and the band went to the duodenum hanging from this tube that is conected to the port. I will first evaluate if your lap band is all inside and if it is I will disconected from the tube at the port and let it go. The patient will evacuate the band without having to repair anything at the stomach or the bowel. Fluoroscopic control needs to be done when the Dr. does it this way…
Comment by Dr. Arturo Rodriguez — July 26, 2008 @ 7:01 am
Hi,
Is it possible to get the lap-band if you need to lose 40 lbs and you have high cholestrol? My BMI is 28.3
Comment by Sepi — August 4, 2008 @ 10:03 am
Hello,
I would say that it is possible to have the Lap band if you want lo lose the extra weigth and maintenance in the right weight to lower your cholesterol by increasing also your physical activity.
Comment by Dr. Arturo Rodriguez — August 13, 2008 @ 10:47 am
Hello Dr.
I have been overweight for 15 years. Only since having bipolar disorder diagnosed and treated with prescriptions that have caused the weight gain. I must take the meds! We have tried various combos to reduce the weight but to no avail. My BMI is only 27.5 I exercise, eat right (but too much) have high cholesterol and take a statin for that. I have lost the extra weigh via diet pills once, but regained. Would you recommend lap band or sleeve for me? I’m desperate to be at my normal weight again. Many thanks for your reply.
Mia
Comment by Mia — August 19, 2008 @ 4:45 pm
Dr. R You banded me in jan of 08 and i have since had 2 fills one on feb 12th ane the other on march 17th I hav’nt felt like I need another fill as I am still loosing weight I have lost 120 lbs up to this point, i was having some reflux so I had an EGD procedure performed and found out that I have esphogitis my doctor gave me an antiacid perscription but didnt seem to work so I went back to the doctor on fri oct 3rd and got nexium which seems to help but I’m still having problems keeping my food down I have been asperating in my sleep and have chest and back pain when I eat like a vice is clamping them together of course the doctors here immediatly want to remove the band but i want to know if it could be an ulcer (which i’ve in the past before being banded) or errosion and what would you recomend me doing?
KIM
Comment by skiutah — October 7, 2008 @ 5:54 pm
Hello Kim,
I recommend you to have 1 cc removed from the band under fluoroscopy and to keep with the meds you are actually taking.
Since you have lost so much weight you don’t need to be very restricted with fluid.
I beleive you will improve from all your reflux.
We are haveing a get together here in Monterrey the first week end in December and I will check the patient’s bands in case you need me.
Dr. R
Comment by Dr. Arturo Rodriguez — October 7, 2008 @ 6:39 pm
Hey, hope this comment works I’m still pretty new to this whole blogging thing.
Thanks for the interesting dieting post! I stumbled on your blog while
searching for other people’s dieting stories. I’ve actually just started blogging about
my diet tips.
I lost over 30 pounds in a month
with a diet I developed! get back to me about it!
Warmest wishes,
-Joan
Comment by Weight Loss Blog — December 21, 2008 @ 12:43 am
i was wondering do u have to be put to sleep for this banding procedure or can u have a spinal or are there other options
Comment by amy — January 7, 2009 @ 6:35 pm
Hi,
General anesthesia is needed when using key hole surgery-Laparoscopy…
Comment by Dr. Arturo Rodriguez — January 9, 2009 @ 2:39 am
Hello,
I have had the band for one year. Recently I have had sever pain near my port and also have been experiencing a lot of gas build up outside of my stomach. What are the symptoms of erosion?
Comment by Dave — January 13, 2009 @ 10:39 pm
Hello Dave,
30 % of Lapband Erosion starts with symptoms at the port area. Most cases shows lost of all kind of food restriction. A history of repeat vomiting, alcohol, medications as aspirin or other gastric irritants are also present. The need for having a fluoroscopic check of the lapband is imperative in order to rule out lapband erosion with a very high diagnostic accuracy. Some times is needed to have an endoscopic revision to complement the diagnosis.
Comment by Dr. Arturo Rodriguez — January 14, 2009 @ 12:22 am
Hello Dr, I have three questions for you. I have just been banded 4 weeks ago. My doctor never informed me of any possible complications. In fact I only saw him for 3 minutes when he asked me what I wanted, band or bipass. The next time I saw him was right before the surgery 4 months later. I only talked with the nutritionist about diet. I was told I didn’t need a post-op follow-up either. Just a fill once I stop loosing 2 pounds a week. Is this typical? I feel like a piece of meat. Anyway, I suffer from migrains. My normal routien is 800 miligrams of ibuprofine followed by an immitrex shot. Is there such thing as home ibuprofine shots? I don’t have a problem with the big needles expecially when I am suffering with a migraine. Also, when should I feel normal again. I have servere abdominal muscle spasms, intermittent stomach burning sensation, painful hiccups, and it feels like I have bones stuck in my throat. -Melissa
Comment by Melissa — February 8, 2009 @ 7:51 pm
Hello Melissa,
The lap band patients need to be in close communication with the doctor to avoid complications and that is part of the post-op follow-up care needed for the lap band procedure.
The Lap band fills are done in case to case bases.
In your case I would recommend to talk with your doctor about the meds you are actually taking and make some changes to have more specific medication for migraine and to quit the anti-inflamatories.
Sounds like you have severe esophagitis and probably the pouch is swollen also. You need to protect the stomach with Maalox and Prilosec and take some fluid out of the band while you improve and also move to a free irritant diet.
Comment by Dr. Arturo Rodriguez — February 8, 2009 @ 8:48 pm
I have had my lap-band for a year.I recently had a Laproscopic splenectomy by the same surgeon who did my lap-band. I immediately after surgery noticed a difference in my band and asked the doctor if maybe he had to remove the fluid he said no. Three weeks later In gon in for a fill, and find out my tubing has come disconnected. The doctor says its a easy prcedure to correct. How common is it for the tubing to come disconnected and is this something easily repaired.
Comment by Linda S. — February 24, 2009 @ 3:40 pm
I noticed that this is not the first time you write about this topic. Why have you chosen it again?
Comment by Random T. — April 22, 2009 @ 1:59 am
I have been writing about generalities of the Lap-band procedure since long time ago but people seems to be more interested in the complications and I believe is because when the complications shows up like lapband erosion the patient feel devastated and helpless…
Comment by Dr. Arturo Rodriguez — April 22, 2009 @ 8:13 am
Hi, courteous posts there
thank’s exchange for the gripping information
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Comment by reippeplatuig — June 5, 2009 @ 8:46 pm
I’m concerned that I may have a problem with my Lap-Band causing bleeding. I will frequently have reflux problems throughout the night and will wake up with a feeling that there’s something ‘fermenting’ in my stomach – even though I hadn’t eaten for 12 hours. This morning at around 9AM I spit up some of stuff and it looked like watered down chocolate pudding. The last time I’d eaten anything at all was 8PM last night (some popcorn). Is this something I should be concerned about?
Comment by Eric — June 11, 2009 @ 7:39 pm
Hello Eric,
I would recommend to you to have removed all the fluid from the Lapband and also to have an endoscopy done to rule out any chances of bleeding or the presence of agastric ulcer.
You should be taking antacids like Maalox and Acid blockers plus a diet without irritants…
Comment by Dr. Arturo Rodriguez — June 12, 2009 @ 7:13 am
Hello I just two weeks ago had to have my band removed from an infection of the port and an appendectomy was also performed which had infected as well,my question is my surgeon said I could not get my band replaced but could chose another procedure. I do not know what caused the infection as I had no fills for over 5 months,my question is this do you agree after an infection and removal a new band should be avoided?
Comment by Delores — June 24, 2009 @ 4:22 pm
Hello Delores,
I do re-band many patients from other doctors after they failed the first time for any reason at six to eight months of been de-banded.
Placing a new lapband it is not an easy task because of the adhesions and the scar tissue and many doctors want to bypass this situation by offering other bariatric procedures.
I think that at the end taking proper care to the adjustments and to the diet will make possible to succeed this second time as many patients have shown.
Arturo Rodriguez, MD
http://www.thebariatric.com
http://www.bandstersforum.com
Comment by Dr. Arturo Rodriguez — June 24, 2009 @ 10:27 pm
Thank You for your reply,I will be looking into rebanding or maybe I will chose the sleeve as a second option.
Comment by Delores — July 10, 2009 @ 7:15 pm
I just found this website because I am trying to find answers. I am not satisfied with the customer service I have been provided by my Dr. I have been banded almost 4 months. Only had one set back, was over filled and had to have some taken out. That was about 6 weeks ago and it has been smooth sailing. Until the last week or so. I am nauseous a lot. I have not changed my diet or added anything new (I am NOT pregnant either!!) I am the most nauseous after I eat for about an hour or two. Just a really crappy feeling in my stomach. I am now worried about erosions or ulcers that I have read about. I was also taking ibuprofen for a few weeks for an unrelated issue (800mg once or maybe 2X a day) and I wasn’t aware that I shouldn’t take NSAIDS. I also drink 1-2cups of coffee a day (again, wasn’t instructed on that either). Is there anything I can do for the nausea? My Dr just told me to eat less!! Although I tried explaining it wasn’t pain from overeating or food getting stuck, but he didn’t care. Just told me to eat less and call back in a week or two. Any advice??
Very frustrated!!
Comment by Julie — September 30, 2009 @ 5:23 pm
Hello,
Sorry to hear you are not getting a proper follow up by your doctor…Need to protect the stomach with antacids and acid blockers also (Maalox and Pepcid complete) and quit the irritants…
Comment by Dr. Arturo Rodriguez — October 3, 2009 @ 5:08 pm
My son who is now 23, had a lap banding 2 years ago. He has lost about 60# and has done well until recently. He has developed flank pain that doesn’t seem musculoskeletal and over the past week hymptomis and bright red blood in his stool (about 3 T). He denies feeling sick, does admit to drinking alcohol (3 glasses wine per week), doesn’t take NSAID, but does eat some spicy food. The blood is now not associated with back pain. He is waiting to see his doctor. I found this site as a fluke thing, just googling in his symptoms of Blood in Stool AND hymptosis AND back pain…..didn’t realize the band could erode. Does his symptoms sound like erosion to you. AT first he had delayed weight loss so I know his doctor did fill him quite often. If he has erosion then my understanding is that the band has to be removed?
Comment by pattyvickland — October 7, 2009 @ 11:48 am
Hello Patti,
Blood coming out anywhere requires prompt attention…
Symptoms associated with blood in the stools can be cause by many diseases but one of them could be Lap band erosion.
Removing all the fluid in the lap band as a first step is needed plus H2 blockers and antacids when lap band erosion is suspected.
Need also to have an endoscopic check up and in many cases that the bleeding source is not found a colonoscopic revision is required.
Some of the patients had the band been removed under this circumstances
Dr. Arturo Rodriguez
Comment by Dr. Arturo Rodriguez — October 15, 2009 @ 9:17 pm