Lap Band Leaks: What You Should Know
A Lapband leak is suspected when a patient that previously had adequate restriction feels a change in the amount of restriction. This can happen suddenly or over a period of time, depending on the size of the leak. If there is a leak of the lap band, the band will not be able to be adequately filled and will not provide restriction, or function properly. There are four types of lapband leaks that can occur to the lapband once it is placed, based on the location: (1) Leaks at the lapband balloon, (2) Leaks at the lapband tube connections, (3) Leaks at the body of the tube, and (4) Port membrane leaks.
(1) Leaks at the Lapband Balloon
Leaks in the lap band balloon can be unintentionally caused by needle punctures during surgery, or may occur over time in certain factory weak points of the balloon.
Leak at Lapband balloon http://www.thebariatric.com
Figure 1.0 In the figure above, you can see the lap band (white rectangular shape), which has been filled with contrast fluid. The arrow points to a small amount of fluid that has moved outside the band from a small leak in the balloon of the lap band (VG).
Lap-Band Leak http://www.thebariatric.com
Figure 1.1 This is another image of a lap band balloon leak. A thin line of contrast fluid can be seen outside of the lap band, surrounding both the band and the tube.
Lapband Leak http://www.thebariatric.com
Figure 1.2 The lap band balloon can be seen in the centre of this image (rectangular shape, slanted to the left). In this case, there is a larger leak of contrast fluid which is more easily visible around the lap band balloon (arrow).
Lapband leak seen during surgery http://www.thebariatric.com
Figure 1.3 In this case, there was a leak in the lap band balloon, and surgery was required to remove the band. During surgery, the leak was very clearly seen when fluid was pushed through the lap band, to reveal the location of the leak. (The arrow points to the line of fluid leaking from the AMI band).
(2) Leaks at the Lapband Tube Connection
Leaks can occur within the Lapband tube connection if there is a break or fracture of the tube next to the metal connector. Breaks or fractures may be due to physical movement over time, when considering the materials of the connections (metal and silicone). If the “fracture” is complete, it can be easily diagnosed with an x-ray film (plain film), without needing to inject contrast fluid.
Lapband plain x-ray film http://www.thebariatric.com
Figure 2.0 Above, we can see the lapband port in the lower, right corner, with the tube extending to the left in the x-ray image. There is a complete fracture (break) in the tube. The distal end of the tube is near the port, which means the tube may still be in the abdominal wall.
Lapband Leak http://www.thebariatric.com
Figure 2.1 Above, we can see the lapband port near the bottom of the x-ray image, with a complete fracture (break) in the tube, which is curled up at the top of the image. This shows that the tube is likely still inside the abdominal cavity.
Port of a Lapband leak http://www.thebariatric.com
Figure 2.2 Above is a photo of the lapband port that was removed during surgery from Figure 2.1.
If the “fracture” is incomplete, it is necessary to inject contrast inside the system in order to diagnosis the problem.
Figure 2.3 This shows an incomplete fracture, with the tube in place.
Port of a Lapband leak http://www.thebariatric.com
Figure 2.4 This is the port removed from the above case (Figure 2.3).
Port of a Lapband leak http://www.thebariatric.com
Figure 2.5 In this plain x-ray film, the port can be seen in the bottom right corner. There is a slight bend in the tube at the connection point (upper right corner of the film).
Figure 2.6 As a leak was suspected, contrast fluid was passed through this lapband port. A large amount of contrast fluid is seen at the bend, in the top right (the connection point).
In some cases, it is not possible to indentify a leak with x-rays. Therefore, the diagnosis of a leak may need to be done at the time of surgery.
Lap-Band Leak http://www.thebariatric.com
Figure 2.7 In this x-ray with contrast fluid, there is no evidence of a leak.
Tube leak near the port http://www.thebariatric.com
Figure 2.8 This leak was not demonstrated with x-rays. As the leak was suspected, surgery was required to find the location of the leak.
(3) Leaks at the Body of the Tube
These lap band leaks are usually iatrogenic. This means that the leak was caused by an unintentional needle puncture, during a fill that was done without using fluoroscopy to guide the needle. These kinds of leaks are very common in office fills. Even in the best hands, there is always a risk of puncturing the tube during a lap band adjustment. This is one of the reasons that we always recommend fills to be done under fluoroscopy.
Lapband tube puncture http://www.thebariatric.com
Figure 3.0 A leak can be seen in the body of the tube, close to the connection. This leak was made with a needle at the time of an adjustment (office fill).
Lap-band Tube puncture http://www.thebariatric.com
Figure 3.1 The leaking portion of the tube was removed during surgery.
(4) Port Membrane Leaks
This type of leak usually occurs when the patient has received many fills, or when the adjustment was done using a standard needle. Only Huber (non-coring) needles (Figure 4.2) should be used to perform fills or adjustments. The silicone membrane of the port may be damaged if any other type of needle is used.
Lap-band Port Leak http://www.thebariatric.com
Figure 4.0 The lapband leak is just in front of the port, where contrast can be seen.
Lap-band Port Membrane Leak http://www.thebariatric.com
Huber Needle http://www.thebariatric.com
Figure 4.1 During surgery, we can see a leak at the port membrane as seen by the bubbles that are produced when the port is placed in water.
Figure 4.2 Huber (non-coring) needle.
Final Thoughts
Every day, the lap band manufacturers are improving the design and functionality of the gastric bands in order to prevent complications such as leaks. However, there is always a small risk of leaks over time. Many types of lap band leaks can be avoided by careful handelling the gastric band at the time of the surgery and by doing the lap band fill or adjustment under the fluoroscopy guide, and finally by using the right non-core needle.
Originally posted 2009-03-07 23:31:38. Republished by Blog Post Promoter
Did you like this? If so, please bookmark it,
I have a leak in my lapband near the band. I’ve been told medicare will pay to have it replaced, but with the problems I would rather have bariatric bypass done. Is this possible.
Comment by jamie simmons — May 5, 2009 @ 1:48 pm
Hello Jamie,
How long have you have the lapband?
What is your current BMI?
It is feasible to convert the lapband to a Gastric sleeve and also to a gastric Bypass.
Comment by Dr. Arturo Rodriguez — May 5, 2009 @ 4:13 pm
I’ve only had the lap-band for 2 years, and I have a confirmed leak. My surgeon injected the contrast fluid to find the leak; however, nothing showed up on the scan. Since he can’t determine where the leak is, he isn’t sure how to proceed. I appreciate the fact that he doesn’t want to do any unnecessary surgery, but if you can’t find the leak with the contrast fluid, how do “most” doctors proceed? I’m very eager to get this fixed and to feel some restriction again.
Thank you,
Dawn
Comment by Dawn — June 8, 2009 @ 5:49 am
Hello Down,
I need to know how do you know you have a confirmed leak without showing the leak on the scan?
Is he able to recover any fluid from the lapband? Does he fill your band and you lose restriction gradually or very fast or don’t get restriction at all?
Let me know
Arturo Rodriguez, MD
http://www.thebariatric.com
http://www.bandagastricaonline.com
Comment by Dr. Arturo Rodriguez — June 11, 2009 @ 7:05 am
Since this began (the first time I felt no more restriction) he can’t recover fluid from the lapband. He tracks the amount of saline he injects, and I feel restriction that day. But when I go back (after I can no longer feel restriction), he’ll see how much saline is left, and it will almost all be gone. This all began about 2 1/2 months ago (prior to that, the restriction was perfect).
The last time I had a fill (after we tried the contrast fluid and scan), I felt restriction for about a day and a half, and then, no more restriction at all. So it appears to leak out pretty quickly.
Thank you, Dr. Rodriguez.
Comment by Dawn — June 11, 2009 @ 7:14 pm
Hello Dawn,
I think that doing a fluoroscopic revision with contrast fluid is a better way to find the leaking site.
Around the port it is usually the site of the leaking and from what you are saying I think is also your case.
Let me know if this info helps you to solve your problem.
Arturo Rodriguez, MD
http://www.thebariatric.com
http://www.bandagastricaonline.com
Comment by Dr. Arturo Rodriguez — June 12, 2009 @ 7:23 am
I have a similar problem to Dawn above. I had a flipped port that was repaired six months ago. Had some restriction in the beginning but started in June to have none. Several fill were tried, I have a 4cc band and was filled to 3, each time could only get 1 back out after day or two. Had restriction for few hours. After these fills my incison opened up even though it had been months since repair and when another fill was placed I went to sleep a few hours later on my side and when I woke up the open area had drained out a lot of fluid and the band was once again almmost empty. I wen to my orginal doctor in mexico for a repair of thsi open area and the problem. He wouldn’t say what he did, but since I was awake I am sure that he cut a piece of the tubing off the area near the port. Once I got home I have the same problem. I need help but no oe here in US will touch my band and I don’t know what to do to correct this problem. Thanks for any help you can offer.
Comment by vickie mills — July 23, 2009 @ 1:22 am
Hello Vickie,
At some point you got infected at the lapband port area.
Once a lap-band port gets with infection this one must be removed or the infection will stay long time there and can ruin the lapband system and when this is the case the lapband has to be removed also.
The proper steps should be:
Port removal and then I leave the hose inside the abdomen for one month or 6 weeks until there is not infecction and I am sure that is gone and, then put the port back in place.
Some of the Inamed’s old models had ports that brake easily and have to be change for a newer model also.
Let me know if this info helps you.
Where did you have your surgery done in Mexico?
Comment by Dr. Arturo Rodriguez — July 23, 2009 @ 7:26 am
I was banded two years ago… all was going very well. Two days ago I went for a fill…he gave me .3ml in my 4ml band. ( NOW I HAVE NO RESTRICTION AT ALL) He did not pull out any saline… only added. COULD THE FILL HAVE HAVE PRODUCED A LEAK? Is there any other reason I would have almost perfect restriction and then nothing after a fill? anyone please….
Comment by Shawn — July 23, 2009 @ 10:08 am
Shawn,
How many cc’s you have before this last lap-band fill?
The lapband you have is an old model of Inamed’s band and the port can be damage during a fill.
You need to have the band be checked under fluoroscopy to look for leaks.
At the time of a fill when recovering fluid from the band you need to pay attention to see if is not crystal clear. Changes in color, specifically yellowish indicates the presence of a leak.
Comment by Dr. Arturo Rodriguez — July 23, 2009 @ 5:18 pm
Thanks for your quick response. I had my surgery with Dr. Gonzalez in Tijuana. I have recently been told that the bands that are used in the US are the AP ones and that the ones used in Mexico are 9.75 & 10 what is the difference is it the size measurements. If I get a new band in Mexico what kind will it be. Is there a warranty for a lap band that has a leak in it.
Comment by vickie mills — July 23, 2009 @ 11:09 pm
Hello Vickie,
I never liked the old Inamed lapband 9.75 and 10 (this is the length of the Lap-band) because they were too short and also had a very small balloon (4 cc’s) so I used instead the Johnson & Johnson band (Longer lapband and with a 10 cc balloon)
We have in Mexico, at least in Monterrey Inamed (now Allergan VG models of 11 cms long and a 10 cc balloon) and are the ones I get from Allergan.
I use the VG and the J & J lapband but rather like the J & J lap-band over the others because has been the same length and balloon for 20 years.
Allergan has now 4 models so it is very important to know what you are going to get before surgery.
Comment by Dr. Arturo Rodriguez — July 23, 2009 @ 11:48 pm
Hi. i have had my band for 5 years. 6 months ago i began noticing there was nothing in my band when i would go for a fill. upon the reccomendation of my dr. i had port replacement surgery. during the procedure he put in the new port, pushed in saline and it was not holding at all. my dr. informed me it was not the port. where do i go from here? is there any type of guarantee on these things? thanks
Comment by cindy — August 25, 2009 @ 10:56 pm
Hi I was just wandering I have had my band in for 6yrs, no dramas at all.. Just lately I have noticed the Dr who does my fills tell me that he his getting air bubbles when he extracts fluids before a fill.. do you ahe any idea why this happens..I dont feel my restriction lately either my band holds 12mls and i have 9 in it so far
Comment by roz — September 22, 2009 @ 11:42 pm
Hello,
During an unfill you can get some bubbles and that just reflects either that during a fill you got fluid + air or you have a small lapband leak….I would do fill the band with contrast under fluoro to check the integrity of the system…
Comment by Dr. Arturo Rodriguez — September 23, 2009 @ 6:20 pm
Thank you.. I had another fill of .5mls yesterday and it seems to be ok for now, but i have noticed in the past few fills that within days I dont get much restriction… I was at 7mls for 2years and lost weight over 50kls, then i had it all removed to have surgery on another matter. whilst it was removed i put on 7kilos. when the Dr went to put back in the 7mls it would only allow 4mls to go in, since then i have seperate fills to had up to 9mls.. I thought that maybe putting on the 7kilos with no fluid in the band at all may have changed my stomach and this is why im not having much restirction at 9mls as what i had at 7mls… I guess time will tell..
Comment by roz — September 23, 2009 @ 7:34 pm
Hello Dr. Rodriguez,
I am getting band next week in Tijuana with Dr. Ortiz. He offers the Allergan and J&J band– which ban should I get that is more modern and less likely to have these leaks or problems–
Comment by Kathy M — September 25, 2009 @ 6:54 pm
Hello Kathy,
I either like the long Allergan Model called “VG” and the Quick close Model of J & J.
The Realize band is a more rigid band and we will see many slippages in the near future…
The “AP” Allergan model pretend to tight the stomach as tightening a hose and that is not the case with the stomach’s shape at that level…
Comment by Dr. Arturo Rodriguez — September 26, 2009 @ 6:27 am
I am 56 now. I had the pal band put in last May o8. Just until now I have not had any problems. Now since I did not feel restriction Doctor said I have a leak. I will be going on Oct.22 to surgery to connect again and possiably replace Port, I am a big chicken about thing like this. But I have had lost high BP problems and Diabetes. But when I noticed no weight change for the logest and no restriction I knew because I had a small pinching pain about 3 inches from the Band . Well it’s scarey to me but I must hold my head up and thank God I have come this far because without it I did not feel any hope. It has saved my life and I am not giving up .I have come a long way and am not giving up for no one.
Comment by jaonn herrera — October 7, 2009 @ 4:10 pm
just found out that my band is broke and is in the shape of a C and not the circle it had been. have you heard of this happening and what can be done to correct it?
Comment by annette — October 10, 2009 @ 6:41 pm
I am on my 2nd band and now the one I have in is not holding fluid. I know there is no way my ins will pay to have this fixed which is so unfair. I want to switch over to the sleeve but there is no way I can afford this…any ideas?
Comment by Karen — October 13, 2009 @ 12:36 pm
Hello,
Some of the lap bands need to be re-connected to the port and that is consider a minor leaking and to fix it is very simple.
When leaking is at the balloon is due to improper handling of the lap band during surgery and you should talk with your doctor about it to have it replaced.
To check the level of the leaking is very important before going to any surgery.
Doing a check up under fluoroscopy with a contrast dye helps to determine where is the lap band leaking located.
Dr. Arturo Rodriguez
http://www.thebariatric.com
Comment by Dr. Arturo Rodriguez — October 15, 2009 @ 9:37 pm
just believe in your self and your Doctor. Do not put off going to your doctor if you feel no restriction or not losing weight. It’s better to fix the problem soon rather than to wait and have more complications later. Yes it’s a little bit scary but what I had befor my weight came down was a bigger risk. No one ever is going to have the same results exactly but if you really do your part, you will change your life , I am so happy I have lost a lot, and now having a replaced port on the 22nd October, it’s just one more hill to get over. Keep the faith, do not fear, you will be in good hands, The Lord above, and your Doctor, family and friend’s………..
Comment by jaonn herrera — October 18, 2009 @ 2:46 pm
My doctor’s office has never heard of doing fills under fluoroscopy. The technician doing a scan of me had never heard of it. I doubt they know to use a Huber needle to do fills. They don’t even numb my skin before they put the needle in. It is very painful and when she moves it around, it feels like she is cutting through my skin with a knife. My doctor’s bedside manner is horrible. I am at 9.25 cc’s of a 9 cc band and they think that I have a leak because it is very difficult to get anything out of my band. They can put the liquid in and out just fine, but they can’t take any of the old stuff out. They think there is a link in my band which was probably caused when she was poking around trying to find my port. They probably have never heard of injecting the port with contrast either. SIGH. This is what they do for a LIVING!
Comment by Andrea — December 16, 2009 @ 9:52 am
I need “fix a flat” for my band. I’ll give up the adjustable part if I can just get some good permentant restriction without another surgery. I need to lose another 40 lbs or less and would be happy to have some restriction and just live forever with what ever help it can give me. Is there such a thing? what about injecting dermabond… I know this sounds crazy but I cant afford to pay for another band. Im very sad about my leak… Maybe someone has come up with a solution to the problem… heard of any?… Carla
Comment by Carla Taylor — December 28, 2009 @ 6:04 pm
I have had my lapband for a year and a half. Yesterday I began feeling like something cold was running down my side where my port is. Today it continues, usually when I lean over or slouch. Do I have a leak at my port? I do not have the insurance I had when the surgery was conducted…and I do not have the money to pay for redo surgery. Do these things have a warranty? ha
Comment by Donna — January 15, 2010 @ 11:05 am
The proper way to make sure that a leak is causing what you are feeling is to be checked under fluoro.
The lapband procedures do not have warranty.
Do you have restriction at all?
Comment by Dr. Arturo Rodriguez — January 15, 2010 @ 2:19 pm
When there is a leak at the balloon of the band must be replaced.
Many times leaking is caused by improper handling of the lapband during the lapband procedure
Comment by Dr. Arturo Rodriguez — January 15, 2010 @ 2:21 pm
It is very important to do the fill under fluoro because many times doctors and nurses inject the saline in the fat tissue and not in the port….
Comment by Dr. Arturo Rodriguez — January 15, 2010 @ 2:24 pm
You have to check under fluoro why your lapband is not holding fluid before doing anything else…
Comment by Dr. Arturo Rodriguez — January 15, 2010 @ 2:26 pm
You probably have an old lapband model and that was its normal shape…
Comment by Dr. Arturo Rodriguez — January 15, 2010 @ 2:27 pm
Got banded in December, 14 cc band. Have had fills of 3.5, 3.0, 1.2, 1.1, .5. Every time I go in the barium flows right through like it did the first time. Do I have a leak. Or am I paranoid.
Comment by george — March 3, 2010 @ 9:21 am
Hello George,
Is the Doctor recovering any fluid during the lapband fill? When there is a leak the fluid inside the lap band is kind of yellowish and it is much less amount of what is expected…
Comment by Dr. Arturo Rodriguez — March 7, 2010 @ 9:21 am