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
Did you like this? If so, please bookmark it,Tags: Add new tag, complications, erosion, gastric band, gastric sleeve, Lap Band, Lap Band procedure, Lap band slippage, Lap band surgery, lapband big pouch, lapband complication, lapband fill, lapband fills, Lapband mexico, lapband slippage, lapband slippage correction, Lapband surgery, pouch, prevention lapband slippage, slippage
Hello Lisa,
I think you can have soft food in small amounts without a problem.
Do not use protein shakes or vitamins because patients do worse with them.
You can eat chicken, fish, cheese, well cocked vegetables without stretching the pouch.
Thank you so much. I really appreciate your response.
Lisa
Hello!
I’m very thankful I found this site! I was banded in April of 2100 and had my latest fill that took me to 6ccs in August. I haven’t been to my doctor since then because 1) I have been feeling fine, 2) I made the huge decision to quit my teaching job to have more time with my family, which, in turn, means I have no insurance.
So, I am 52 lbs. weight loss and am very pleased with my results. Lately, however, I’m living on Maalox to treat horrible, sometimes painful, acid in the back of my throat. I’ve also noticed that I have been able to eat more than I could just a month or so ago. I am also experiencing very uncomfortable back pain that feels like it’s compressed.
This week I got the stomach flu. Today marks day four that I haven’t been able to keep anything down, including small sips of liquids.
I can’t really afford a bunch of tests, so I wanted to seek direction and advice from you before I jump into anything.
Again, I love that you are here and so helpful! Thank you for your time.
CC
Hello,
I would take a couple of cc out of the lapband for 30 days with acid blockers during that time plus Maalox.
i had a lap band in 2002. i lost 40lbs. in 2008 i had a car accident later that year my lap band had a prolapse and had to be removed 9mos later they tried to put it back thre was to much scar tissue i would like to know could the air bag going off have anything to do with the prolapse
i had a lap band in 2008 i lost 40lbs i had a car accident later that year and the air bags went off afew months later my lap band had to be removed 8mos later they tried to put it back and there was too much scar tissue could the air bags going off cause the prolapse
Hello Valerie,
It is a possible cause that extreme pressure over the abdomen like in a car accident could cause a lapband prolapse. Symptoms should be notice at the same time….It is more common to be vomiting for a long time the causes the prolapse.
doctor straight up i had my surgery 6 weeks ago about to go have first fill. i have been terrible like an addict bad on my discipline of eating. i have gained weight since my surgery and feel like i may have jeopordized my chances of successful weight loss surgery with the band. have my action of eating as if i never had my surgery possible to have also undone my hiatel herniea as well along side other possible issues. i may have caused myself problems due to neglecting my responsibility and severe overeating. is there a pouch before your first fill
Hello J,
You shouldn’t have a pouch at this time.
Just need an adjustment.
I’m having the lapband on Feb. 23rd. Reading all this posts is making me very nervous. My hope is to lose weight and get my diabetes under control. Is it worth having all this complications? Please advise!
Hello Maria,
The purpose of writing about lapband complications is purely informative.
There is a small percentage of lapband complications if you follow your doctors advices.
Be sure what kind of a lapband you are getting because old devices causes much more frequent complications than newer devices.
I had lap-band a year ago, i’v lost 92lbs. At night when i’m sleeping i wake up too many times too vomit too much villi. A very bad burning sour stomach. I called my Dr. and he took me an emergence. He sent me for a be. swallow test and they saw i have a spillage.The Dr. took out 3cc which i only had a total of 5cc. Do you think i really need surgery again? I forgot to tell you, i had a very bad hiatel herniea. What do i eat now? What do i eat now?
I failed to mention that i can’t eat or drink anything.
Hello Lina,
You should had all the saline removed from your lapband if slippage was present.
You have to take acid blockers and Maalox in regular bases plus quitting coffee, coke, alcohol, spicy food and aspirin like medications.
In cases where there is not improvement, they need the lapband to be re-located or removed.
Dr. Rodriquez,
I had my surgery done in May 2011, I didnt have much weight to loose so Im assuming thats why the dr used a 4cc band on me. I didnt get my first fill until July about 2 months later. My first fill was 2cc and from May to February i lost a significantly amount of weight, enough that I was going back in to have a slight unfill because I was unable to eat meat unless it was in very fine pieces or any thing solid without only being able to eat a few pieces or spoons. I went back in this month to get an unfill but when the nurse attempted to take the fluid out, nothing came so that prompted her to do it under flouroscopy. When I drank the barium swallow, you can see I had a small prolaspe or you can say an area where my esophogus on one side was buldging over my band. It didnt look too bad so when she tried again to remove the fluid, she was able to get the 2cc completely out. She told me to come back in two weeks to re-check and to get a fill. I am skeptical of going back in because for one, I am self pay, i had my band placed in Mexico, second the cost for florusocopy is $350 each time and I am still having problems eating anything solid. It feels like I still have fluid in my band when I don’t. I put myself on a 3 day liquid diet because the nurse didnt tell me to go on liquids for the two weeks. I tried drinking/eating very soupy oatmeal and it hurts when any thing with substance pass the area of my band. I am currently in week 3 with the same problems. I am not sure what caused my prolaspe or slippage. I did not have an issue with vomiting at all. Do you think that my issue came from using the 4cc band vs the new band? I was told by others in the US that drs were suppose to discontinue the use of the 4cc band. My friend and i went at the same time to mexico and she got a 10cc band im not sure why i got a 4cc band. What do you think my next step should be? I am considering going back to Mexico to have an adjustment or whatever I may need but concerned about cost. I hate to think I have to pay to have it repaired when maybe the wrong size band was used that may have caused my issue.
Hello Queen,
I hate to say it but you have an old lapband model I discontinue to use long time ago when having the same problems like you are.
Yesterday I spoke with a doctor that say the same thing your doctor told you, that if the patient is not to big enough he uses a 4 cc lapband model.
In the mean time you can have Mallox or Riopan e/4hrs plus pepcid complete e/12 hrs.
The right thing to do is replace that old lapband model for a new one but you have to expend to have it done again.
I had the band done back on December 22,2011.about 2 months ago. I have had 4 fills simce then.I am up to 8.5 cc’s in my 11 cc band. I still don’t have any restriction. Have I gotten too many fills too soon ? Also y am I not feeling restriction yet? I have plateaued already. Only lost 28 lbs. 9 of which were pre surgery
Hello Crystal,
You have to review who is doing your fills.
The first fill I do after a lapband surgery is not done before 1. 5 months so in 2 months 4 fills for me is something very wrong and up to 8.5 it is also wrong.
20 pounds in 2 months is more of what I would expect after a Lapband.
I like the patients to loose weight gradually and to get adapted to change the bad habits for good ones in a smother manner before they start competing with the lapband and vomiting all the time.
I had my lapband surgery May 2009. I have done really good and have meet my goal weight. total lost was 100lbs. I went to my Dr b/c I’m about to have my tummy tuck and breast implants and my
plastic surgeon wanted to make sure it was ok for him to be working around and maybe move it out of the way for the tummy tuck(bc I’m keeping my band not giving it up). My lapband Dr. said he thought it would be just fine. But he noticed I had a slight cough when I was laying down (I had a lil reflux at night) so he took some out of my band. WELL I gained 13 lbs. Stressed out I went back for a fill. He put in .3 cc. Well 2 weeks I couldn’t tell that I was restricted so I went back Friday for another fill to get me back to where I was for my surgery. I still feel like I’m able to eat more than I should. Could I have stretched my pouch?? or have a slippage??? Worried my surgery is 3/28/12.
Hello Tina,
I recommend you to have all the fluid removed from the lapband right before surgery. Many patients have done bad after surgery particularly because the medication you have during and after the plastic surgery.
Do not worry about a few pounds you gained and would be good for you to try to go in a proteinic diet without vitamin supplements or amino acids.
The good thing about the lap bad is that is adjustable so after 10-15 days you can have a fill. The plastic should not have any problem working around the lapband port.
I had my lap band done 03/08/ 2008. I have the allergan VG 11 cc band. I have lost 100 LBS. I have only had four fills. The first 6 wks post-op for 1 cc. and then a second fill of 3cc to prime the band line and 5cc to the band for a total of 8cc. I had acid reflux at nights and in the mornings, but thought it was due to coffee drinking and late meals before bedtime. I also had episodes of right lower quadrant pain. I have been reading and have learned that these are signs of a lap band that is too tight. I began to gain weight and reduced restriction as of Dec 2011. I made a follow up appt. and thought that this may be resolved with a fill. I have had two fills in the last two months and am now at 10.5 cc and still do not fill the same restriction as before. I am wondering if I have stretched out my pouch. Prior to having restriction issues I had a period of about three weeks were I would eat and drink at the same time. I also began to drink carbonated diet coke. I am concerned that I have stretched out my pouch. Should I have my M.D. do a barium swollow? Could my lap band havebeen too tight tight to being with and I have overstretched my pouch, could this be fixed or do i need another surgical intervention? I am very concerned because after speaking to my M.D.and his office staff they have expressed that for the most part all of his lap band surgical patients have not done well. What should I do ?
Hello Veronica,
I do not recommend the office fills for a lapband.
I think that is a very poor follow up for a patient.
You need a barium swallow to have your lapband evaluated.
Thank you Doctor. I am going to ask to have a barium swallow test. All my fills have been done without fluro just by palpation. I am concerned that I may have to have another surgical procedure done and that my lap band will no longer be effective. Can a anlarged pouch be corrected without surgical intervention if that is what is happening ?
Hello Veronica,
Lapband enlarged pouches have to be repaired with surgery.
You need to Barium swallow first to check if the problem is for not having enough of a fill or for a stomach related problems.
Hi Dr. Rodriguez
I had my lap band surgery in June 2007. I did well and lost almost 50 lbs slow and steady until around December. I started having issues with severe heartburn and fluid coming up at night. My dr. initially put me on heartburn meds for a few weeks and finally removed fluid when that didn’t help. It took care of the problem. I soon realized that the weather affects my band – it will restrict when the barometric pressure drops before rain and also when it’s cold out. We started the “fill – unfill” yo-yo for the next year, never able to get back to my “sweet spot.”
I used to be able to feel cold liquids going down and when I couldn’t, I kept feeling something was wrong. Under flouroscopy we discovered I had a slip. My dr. did a revision surgery and used the newer band as a replacement. Being terrified of another slip/prolapse, as the pouch had enlarged, and having lost my insurance, I didn’t get a fill for over a year.
That’s my history, but long story short, in approximately 2 years I’ve only had 2 fills. When the weather changes, I still feel it. I get a lot of gas that seems to put ‘pressure’ up on the band, and sometimes I feel like I can’t feel the cold going down. I don’t believe I have overeaten, especially considering the amount of time elapsing between the two fills, but I’m back to not feeling the cold drink going down again.
I’m sorry this is detailed, but I wanted to give you a little history before asking my question which is: If the pouch has stretched to the point of twisting sideways where it prolapses over the band, what happens to the liquids or foods? Wouldn’t it eventually “back-up”? And if it’s not going down through the band, wouldn’t it lessen the trips to the bathroom? The more I drink trying to “feel” the cold, the more I go, so I feel like something must be going through and perhaps I just can’t “feel” it because of the gas pushing up and the constant weather changes we have (I’m in south Texas). I ‘m not feeling nausea, vomiting or heartburn.
I’d love to have your feedback on this.
Thank you so much for answering people’s questions and taking your time to offer your input.
Hi,
I had my band done in 2007. I had lost about 67lbs. I was doing fine. I had a fill that was to tight I had to go back and have some taken out.
My problem now is I can not tell I have ever been band. I`m hungry all the time gaining back some weight. I do not want to put the weight back on.
There was some question of post surgical changes of adjustment laparoscopic gastric banding with diffuse dilation of the visualized lower throracic esophagus. This was discovered when I had a CT Angio heart W/3D image.
Is it possible this is why I`m hungry all the time? Does it seem that the band has slipped. What do you suggest? Thank You,
Paula
Hello Paula,
I recommend you to have a barium swallow and a fill at the same time.
Dilated esophagus it is frequently seen if you are to tight and you are forcing with food.
Hunger won’t go away unless you do some more physical activity.
Hello Mary,
The old Lapband models where not good in design and very many prolpses and slippages made us change many lapbands or just remove them.
I am glad you have one of the new lapband models.
It is the first time I hear about the barometric effects over the lapband fill so I will pay closer attention to that.
The new Lapband models holds much more of a fluid so I think that having a fill will make the restriction you need.
I would not recommend an office fill even if they are cheaper than the ones done with fluro because we, the doctors, can not detect abnormalities until is to late to solve the problem.
Let me know if this information help to answer for questions.
Hello,
I got my lap band in Feb. 8th. Everything was going quite well up until yesterday. I had my 1st fill on the 28th of March and seemed to do fine, again, until yesterday. I also have a hx of eosinophillic esphagitis which I have difficulty swallowing. Yesterday, while eating some chicken, I felt as though it was stuck in my throat so I took a sip of water to try and guide it down (as I have done for the last 6 years since the dx) however, it was a very painful experience and afterward I spent about 10 min vomiting, most of it looked bright red, I am assuming it is blood. I was unable to get anything food or liquid to stay down since. Any time I eat or drink anything I spend the next several minutes in the bathroom vomiting. Although, there isn’t any more blood, it is very painful and almost feels like a knife or something is in my throat and chest when I eat. As an EMT, I very hesitant to go spend hours in the ER just to be told I am fine. Any in sight on what this could be would help. I hope maybe I just irritated the esphagus and in a few days I will heal.
Hello,
I don’t know what kind of lapband you have and its size but after a lapband fill if the patient is having a lot of restriction I do take some of the fluid out and prescribe Maalox e/4 hrs and omeprazole or ranitidine e/12.
I had my band on 6/2011. I am down 57 pounds. Had an un fill two weeks ago. Severe abdominal pain and radiating left shoulder pain when I eat solids. Told that things were fine. I have 5cc in my AP lap band. Is sleeve revision an option if I have a slip or pouch dilation?
Hello LaShandra,
I think you will do well with your band because the pain you had is related to swelling of the pouch or the esophagus.
Any way, gastric sleeve is a very good option for patients with lapband complications and for patients that they do no long want to have the lapband.
I have had my band for 15 months and for the past couple weeks I haven’t been able to eat really are drink with out feeling uncomfortable. I just started having problems drinking are eating in the mornings. Does this sound like a slip?
Hello Jay,
Sounds more like swelling at the level of the lapband.
Start a liquid diet and take some Maalox 4/d and ranitidine or omeprazole e/12 hrs.
If this do not work after a few days you will need a barium swallow and removed some fluid from the lapband.
Hi Dr. Arturo,
I was banded in 11/2010. I had to have a port revision in 2/2011, and a tube replacement in 11/2011. Since the tube replacement I have been losing great, eating right, and being active. I went and had a slight unfill 3/2012 taking me down from 7cc (in a 10cc band) to 6.5 cc. I wanted to increase my activity level and my food intake slightly so that I would have the energy to do the workouts I wanted to do. Since my slight unfill, it has been harder for me to eat. I know wake up some nights (not every night) coughing and sometimes gaging on acid reflux. The mornings after I cough a lot I have pain in my chest but only above my left breast. I haven’t eaten foods that I shouldn’t and I know what having something stuck feels like and this isn’t that. I was wondering if you think I might have a slippage. I really don’t want another surgery.
Hello D.D
Have you been taking any vitamins or protein shakes after the lapband unfill you had?
It sounds more to me that you are swelling at the pouch level so take some Maalox and acid blocker and do not try to eat solid food for a few days and see if that help.
I have a lap band for 4 years now. Everything is great I lost 50 pounds I’m 129 now, but my port was visible and embarrassing so I asked my surgeon to remove just the port and he did, now I’m worried is it safe ?
I had the lapband 2 yrs ago and lost 70 lbs.. I’ve had several fills and the this last fill I had I went from not being able to eat anything or 2 wks.. To eating anything. I don’t feel any restriction and I’m wondering if there is a problem.. I feel fine but I would the to ind out it slipped bc I’m not sure if insurance payes for a revision…
Hello Dee,
It is a safe procedure to remove the lapband port but you need to know that you have to be very careful on what you eat, drink and meds you take. Avoiding swelling of the pouch it is the key.
Hello Ace3,
You need a barium swallow to have your lapband checked.
Hi there Dr I am post op being in my 3rd week on puree food… I am so hungry and starting to eat more stronger foods but chewing and mashing up in my mouth I still have a few weeks to go until my 1st fill what should I do about the feeling of being hungry all the time thankyou.
Hello Debbie,
You can eat soft food. You do not need to be in a puree food.
Dear Dr. Rodiguez,
I had a Gastric band inserted in Dec. 1996.(I weighed 220 lbs at the time and was 5 ft. 6. in). I now weigh about 170 lbs.) Seven months later (July 2007), the band had to be replaced because there was a defect in the band (the manufacturer paid the costs).
6 weeks ago a barium swallow confirmed that the band has slipped. The chief surgeon wants me to have a sleeve resection. The assistant to the surgeon says I should have a gastric bypass. They are discouraging me from either having the band corrected or a new one inserted. They say the lap bands are not the treatment of choice any more at their hospital.
I live in Germany. I had the surgery done in Belgium and self-payed at the time. In Germany now my surgery would be paid by the national health service. I am wondering how that influences their recommendations. Is the gastric band still being inserted because for many self-payers it is the most reasonable alternative for bariatric surgery. But are the other procedures more the gold standard and gastric bands the poor cousin.
Truly, I would like to have the gastric band repositioned or a new one inserted, I am not yet ready to cut away a part of myself.
I may have to go back to self-pay in Belgium because I am not sure they will do the procedure here in Germany.
At the same time, I want to do the best medically for myself.
I sense that I prefer a phased treatment (trying another lap band first, and if that doesn’t work, considering sleeve resection.
The doctor did mention that because I am 62 (in good health otherwise, I am also active), my age was a factor. For what, I am not quite sure.
What would you suggest I do?
Replacement or repositioning the lap band first. If it slips again, then
Sleeve resection (on which there are no long-term studies).
I’m not ready to do a Bypass. That I am sure about.
Hello Linda,
Many times, comments of doctors on what to do next comes from personal experience and the ability or skills gained in laparoscopic surgery.
Most of the times it is feasible to place a new lapband like in your case. There are patients that the surgeon can’t do the procedure and it is better to go for the sleeve rather the gastric bypass.
It is wise to research on your doctors experience, the time doing bariatric procedures, the doctor’s preference choices for bariatric surgery, amount of patients he handle.
Hope I answer your questions.
Hello Doc-
I was banded Nov/2011 and have the VG band holding 11cc’s since my banding I have always had issues, my fills are either too much or not enough and once it even took me to the hospital due to a minor sillpage. I have been to my doctor’s office 4 times since Nov 2011 to get my band filled or unfilled. I have spoken to them today (just got it unfilled to 3.6cc) about the options of getting a Sleeve or Gastic Bypass and although I am scared of having surgery again, I am just so fed up with my lap band and don’t even want to get another fill.
My question is, after my unfill today, I went from 6.6cc to 3.6cc, I am feeling nauseous and feel sick to my stomach. I can tolate liquids but wondering why I feel so yucky? I have taken prevecid, should I take nausea meds too? Please let me know.
Thanks-
yvette
I am sorry correction, Iwas banded Nov/2007
Hello Yvette,
3.6 it is too little of a fill for having restriction after 4 years of been banded.
I would suggest a barium swallow and be checked for slippage.
Taking nausea meds are OK but antacids and acid blockers also is OK.
Hi Dr i was reading all the comments and I was wondering I had one of the old lap bands that arent adjustable placed yrs back well i had that removed and the dr put a 10cm band which only holds 4cc? Why is that? Is it smaller than other people? Or was it because of my previous band?
Hello Karla,
The 4 cc Lapbands are the old version. I don’t know why your doctor decided to place you an old model. I don’t do it.