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
Did you like this? If so, please bookmark it,Tags: De-banding, Health, Lap Band erosion, Lap Band Failure, Port Infection, Stomach erosion
Hello Mary,
Yes, the removal and doing the gastric sleeve can be done at the same time unless there is an erosion.
Your coughing reflux it is cause by a tight gastric band or slippage.
Is it difficult to remove a Molina band. What are some of the issues. Can this band be revised to the sleeve and does it have to be 2 surgeries?
Hello Michael,
You could have the 2 procedures in one time unless there is an erosion of the Molina Band into the stomach.
I have a molina band had a EGD said did not see the band, what does that mean
Hello Mary,
Most probably cause they didn’t see the band it is because the Molina Band it is not seen with X-rays.
They could see that there is restriction at the upper stomach. Many Molina bands melts with the stomach wall.
What you need is an endoscopic evaluation of the esophagus and the stomach, by doing it will answer many questions about your respiratory problems and will tell you if you are a good candidate to have a sleeve.
Hello there,
I’ve had the lapband since 2008 and I have gained all my weight back unfortunetly. I have been experiencing burning sensation, loud noises, belching (even when I haven’t eaten), passing a lot of gas in my sleep (per my husband says) and pain in my stomach for the past month or so. I haven’t had a fill in year. I’ve been off of remicade & methotraxate for a year now. Just taking Ibuprofen or over the counter pain. Herbel Turmeric, fish oil, vitamin D.
I suffer with RA and I’ve had that way before I got the lapband. What shall I do?
Hello Dee,
You need to quit the Fish oil, vitamins and Ibuprofen and have Maalox and Pepcid compete en regular bases.
After 10 days of having quit all of that have a fluoro check and if is the lapband tight tell them to remove some saline and wait for a month until all comes back to normal.
Thank you Dr. Rodriguez!
I was also wondering what should I take for the Rheumatoid Arthritis inflamation and pain while coming off of the fish oil, vitamins, ibuprofen etc.
What type of foods should I eat during this 10 day period. I have pain around the ban area. Do you think it’s due to gaining the weight back? I haven’t had a fill in almost 2 years now
Hello Dee,
I recommend you to eat soft food, wait 10 days and see if is any improvement and just in this 10 days take tylenol for pain, then you start again with your ibuprofen. If this does not work have an unfill.
I have a Molina band. I recently had EGD which was normal. They also said stomach and eshogus was normal and did not see the band. What does this mean could not see the band. Also would I be a good canditate for the sleeve? Also can you get the adjustable band?
Hello Mary,
EGD’s are good for looking for stomach erosions after been banded. The Molina band is a non-adjustable band and depending on your doctor’s preferences you find what kind of material he uses for giving you restriction.
I’ve done gastric sleeves in patients with Molina band and during the gastric sleeves I’ve done I notice that take me longer time due to scar tissue formation but besides that everything was OK.
I had a Molina Band done in August 1995. I weighed 495lbs and lost 175 in a year. I never had any real issues besides the occasional vomiting due to over eating or consuming something too dry or not chewed well. I eventually started gaining the weight back and by 2004 I had gotten back up to 411lbs and consulted with a bariatric surgeon about the gastric bypass. He, of course, needed to do a scope to see what damage the existing band had done in my stomach and as suspected, it had erroded into my stomach and he couldn’t completely remove it. He snipped and released it and did the bypass but unfortunately, he was not able to make the “pouch” as small as it was supposed to be. Therefore, I am able to eat more than I would be able to. I did lose weight…112lbs within a year but I was back up to 375 by September 2010. I have since been diagnosed with hypothyroidism and have been regulating it with meds and have lost weight. Right now I currently weigh 320lbs and I would love to consult with another surgeon to see if I would be eligible for the the new “sleeve”. Has anyone gone through the same issues stemming from the Molina band and if so, is this a possibility after having two weight loss surgeries? I know that the Molina band probably saved my life at the time but both my parents had it done as well and have gained all their weight back plus some! Not to discredit the late Dr. Molina, but isn’t ironic he passed away due to health issues caused by obesity. :-/
Hello Dawn,
I am sorry to know about your weight loss surgieries failures.
There are endoscopic suture treatments for big pouches and also for closing the outlet of the bypass when they do not give you the proper restriction. I don’t do it myself.
What you called a new sleeve is the gastric plication and in cases that there is not too much scar tissue can be done over the pouch. Did you have your bypass done laparoscopic or as an open surgery?
I had a Lap Band in 2010 I love my band I haven’t gain back any weight. I have lost about 114 pounds. But resently I started having chest pains they found Barretts in my esophygus. And said my band was loose and there was a inflamation above the band and a recent bleed below the band in my upper stomach. I don’t want to loose my band am I endanger of that? I have a lot of chest and stomach pain. I also loose my food but that is my faultfor eating things I shouldn’t and not chewing well.
Hi Mary,
You can have Barrett’s with or without the lapband.
You have to follow Barrett treatment with acid blockers, anti-reflux meds and also probably cauterization of the Barrets.
The lapband should have 1/2 of the restriction while in treatment.