Lapband Slippage: Causes & Prevention
A Clinical Study
A clinical study was done in Germany to review complications following lap band surgery. Thirty-five hospitals were involved in the study, with 4138 patients that underwent gastric banding over a five-year period. Lap Band long-term complications were described in 8.6% of all patients. The most common complications included: pouch dilation or enlargement (5.0%), lap band slippage (2.6%), and Lapband migration or erosion (1.0%). (Stroh,C Manger, T “Complications after adjustable gastric banding”, Chirurg, 2006, Vol 77,pag 244-250)
Normal Lap Band X-Ray Under Fluoroscopy
Enlarged Lap Band Pouch
What is Lap Band Slippage?
One of the long-term complications of lap band surgery is called “Lapband slippage” and can be defined as “when the Lapband and the stomach pouch are both prolapsed.” This means that the lap band has shifted position and the enlarged stomach pouch has also shifted or twisted so that food does not go through the lapband into the rest of the stomach. This may result in pain, discomfort, decreased appetite and inability to eat or drink, and vomiting. Lapband Slippage does not happen immediately but may take several months to develop.
Large Lap Band Pouch
Lap Band Slippage generally develops in a progressive manner. As food intake is increased, the stomach begins to stretch and grow and the patient may stop losing weight or start to regain weight. At this point, patients may only exhibit an enlarged stomach Lap band pouch. This can be medically treated by deflating the lap band to release pressure and slow the growth of the pouch (successful in 70% of cases, or surgical treatment can be considered). However, if the enlarged lapband pouch continues to grow, the lapband progressively rotates until both the lap band and the enlarged pouch become prolapsed, resulting in Lap band slippage. This is followed by functional stenosis (narrowing) of the stomach.
Lap Band Slippage
Lapband Slippage Symptoms typically include progressively worsening reflux, vomiting and epigastric complaints, which may increase to sudden near-total dysphagia (inability to swallow or eat anything, including saliva).
Risk factors or causes of lap band slippage include surgical technique, model of the lapband used, early consumption of solid foods, early inflation or filling of the band, consumption of carbonated or sparkling beverages, and frequent vomiting.
Treatment for lap band slippage requires surgical intervention. The lapband must be repositioned or removed, based on the operative findings and condition of the stomach pouch. If appropriate, the surgeon and patient may elect to choose another type of bariatric procedure such as a Gastric Sleeve.
How Do I Prevent Lap Band Slippage?
In order to decrease the risk of developing lap band slippage, it is important to follow the recommended diet following surgery and to avoid introducing solid foods too early. In addition, the fills should not be started before 6 weeks post-operatively and these Lap band fills should be very gradual. We also recommend that fills should be done under fluoroscopy, even if you are asymptomatic (no symptoms of lap band slippage), to be able to monitor the position of the lapband, and the size of the stomach pouch and condition of the esophagus. This will allow for early diagnosis of an enlarged stomach pouch or possible lap band slippage.
Originally posted 2009-02-17 13:25:15. Republished by Blog Post Promoter
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Hello Doctor,
I have had my lap band since 10/10/08. Since then I have had the port changed and repositioned due to it being flipped and then 3 months after that surgery the port flipped again. I have not had a revision and have not had a fill or unfill in a year. I had a 10cc band with 6.2 cc in it. For the last 3 months I have been having sharp pains in my band and until recently they would come and go. I also have been able to eat anything I want since the port revision with no restriction. I now have this pain all the time and am having trouble with solid food. I can eat yogurt, jello and can drink liquids but this causes pain also. The pain is like I have a rock in my stomach and hurts all the way into the port site and in my back. could this be erosion or a slippage? I have been reading that the surgery I had is no longer done because it causes erosion. The Doctor pulled the lower part of my stomach up over the band and stitched it there to prevent slippage.
Thank you.
Hello,
You should have a barium swallow and port re-location as soon as possible.
The lapband surgery is still the first choice of surgery if you don’t want to have a bigger operation to lose weight.
You need to take Maalox e/4hrs and acid blockers while you get your test done before you need to run to the ER.
I was banded in october 2010, with a Lap-band AP system large with max fill fo 14cc…less than a week later i was hospitalized with kidneys stones…i was vomitting with the stones before going to the hospital(didnt know it was stones) i have had very little success with my band at all since then…i have had fills 3 to be exact with the last one being a large one according to my doctor. only the first one did he use ultrasound but he said only to find the port…anyway i have not had the feeling of full at all since the beginning..i lost weight (15 lbs)in the beginning because i was starving myself…the first fill was 9 wks post op and i had lost only 11 pds and then the second visit was only 4 pds. I quit going because i felt belittled because i had to drink when i ate or the food wouldnt go down it felt like it was getting stuck in the back of my throat. i had a hiatal hernia repair at the same time as the band insertion….i wont go back because i havent lost any more weight and i feel like they dont care…but lately i have been having pains in my abdomin and around my port…i think it slipped with all of the vomitting in the beginning…i am desperate to fix whatever is wrong with it. I am thinking of going to another doctor in mobile, mine isnt friendly and am not comfortable with him anymore…
Hello Loreinala,
Using ultrasound to find the Lapband port do not talk very well about your doctor skill.
I would suggest to have a check under fluoroscopy to evaluate properly your lapband status.
i am going to try another doctor in mobile…but i have wondered ever since it was placed and i had kidney stones which caused my vomiting excessively before the sutures healed if it was still in place…does it sound like it …i mean i have had absolutley no results in a positive way at all since the beginning and no one in the doctors office seems to care..its all my fualt it didnt work
Hi,
Yes, try another doctor that can do lapband fills under fluoro and that could give you an idea on why isn’t working.