The gastric band (Lap-Band) and gastric sleeve are two common bariatric (weight loss) surgeries.
Both can help you lose excess weight if you are morbidly obese (which means you have a Body Mass Index (BMI) over 40. At that weight, you are more susceptible to a host of ailments like type 2 diabetes, sleep apnea, cancer, and early death. Bariatric surgery like the Lap-Band can decrease your risk of those diseases, but the gastric band has fallen out of favor as a viable weight loss procedure.
It wasn’t always that way. The Gastric Band was once thought to be an excellent solution to obesity. By wrapping an adjustable and temporary medical device around the upper portion of your stomach, the Lap-Band limits the amount of food you can eat. You end up consuming fewer calories, which leads to fast and significant weight loss.
Problem is, lately it’s been discovered that the Lap-Band comes with a high risk of complications, and many who have the device fail to lose the expected amount of weight. This forces up to 70% of gastric band patients to seek Lap Band Removal after around ten years.
The reasons for seeking the reversal include band slippage, breakage, or symptoms like gastric reflux. By having the device removed, many of these issues diminish and disappear on their own.
But to have the adjustable gastric band removed means that your stomach will revert back to pre-surgery conditions. It means that you could relapse to old (bad) habits. Any weight you may have lost with the gastric banding could stall or reverse entirely if you end up overeating, which could lead to the dreaded phenomenon of extreme weight regain!
How to Keep Losing Weight?
To keep you from gaining weight, bariatric surgeons now have an option. It is a combination of lap band removal surgery with laparoscopic sleeve gastrectomy (LSG). Also known as the gastric sleeve, this amazing weight loss surgery will let you continue your health journey seamlessly without missing a beat. Both surgeries – the removal and gastric sleeve – can be completed in a single procedure for limited downtime and a range of other positive benefits.
Let’s look at how this 2-in-1 bariatric procedure takes place and, most importantly, let’s determine if it’s safe. Knowledge is the power. Knowing these facts will better prepare you for the consultation you are soon to have with a bariatric surgeon near you.
How is the Lap-Band Removed?
The procedure for removing the Lap-Band is similar to the one for implantation. If you currently have the Lap-Band, you may have been under general anesthesia during the procedure, so you have no idea how it was performed. Here’s a short rundown.
First, your bariatric surgeon made a series of small incisions in your abdomen. These cuts acted as openings for the laparoscopic tools used during surgery. These tools were operated remotely. They allowed your doctor to work inside your abdominal cavity while viewing the action on a nearby screen.
During that original surgery, the lap band device was secured around the upper portion of your stomach. In many cases, the area around the Lap-Band was also fitted with sutures to keep the gastric banding in place and to prevent slippage.
Gastric band removal uses the same technique, only in reverse.
During the reversal surgery, and unless there were complications during the first one, your surgeon will use the same incisions. The incisions allow for the laparoscopic tools to be inserted and for the gastric band to be removed.
First, your doctor will cut away any scar tissue that may exist around the gastric lap band. The tubing and banding will be cut away before the entire apparatus is pulled out from around the stomach.
The sutures that made sure your Lap-Band didn’t slip are removed and the areas around them are treated to prevent infection. With the gastric band removed, your surgeon will often cut away the perigastric capsule, which is dense scar tissue around the upper part of the esophagus or stomach. Performing this extra step prevents obstruction following surgery. Your surgeon will then remove the subcutaneous port before proceeding to the sleeve gastrectomy.
That’s all there is to gastric band removal. Let’s look at the gastric sleeve.
What is a Gastric Sleeve?
Laparoscopic sleeve gastrectomy (LSG) which is also called sleeve gastrectomy or simply gastric sleeve, is a permanent weight loss surgery that, like the Lap-Band, restricts the amount of food you can eat. The technique began as an alteration of another bariatric procedure known as the duodenal switch procedure. The doctors soon determined that gastric sleeve on its own was effective enough for weight loss. Therefore, many doctors began offering the weight loss surgery on its own, and with impressive results!
The gastric sleeve can help you lose up to 80% of your excess weight and is associated with low complication rates. The procedure involves the removal of around 75% of your stomach, which leaves behind a banana-shaped pouch. This pouch or “sleeve” is where you will store the food you eat on its way to being digested. By limiting the amount of food you eat, you consume fewer calories, and you lose the excess weight fast.
Gastric sleeve surgery simultaneously affects the hormones in your body that drive hunger and satiety. This triple-threat against obesity means you will eat less, feel less hungry, and feel “full” faster with every meal.
If the lap band failed to work or caused you problems, the gastric sleeve ups the ante to ensure you continue losing weight fast, the healthy way, and without complications or nutritional problems.
How Do Surgeons Transition from Lap Band Removal to Gastric Sleeve?
In bariatric circles, transitioning from lap band removal to gastric sleeve is known as lap band reversal surgery. Lap band reversal allows your surgeon to add another bariatric procedure in the place of the failed gastric band. Here is where the gastric sleeve comes into play.
Like the Lap-Band, the doctors perform the sleeve gastrectomy laparoscopically. They don’t need to use new incisions because they can use the same incisions and tools from the gastric band removal surgery.
Your doctor will remove the necessary portion of your stomach, leave the sleeve portion behind, before closing the incisions. The good news is that those incisions are typically hidden within the natural folds of your body. Any scarring will be minimized as a result or hidden entirely once they heal.
This combination of Lap-Band Removal and Gastric Sleeve is fairly straightforward. It is an excellent way to resume your weight loss journey if the Lap-Band failed or caused you problems.
Now comes the big questions: Is it safe?
Is the Combination of Lap-Band Removal and Gastric Sleeve Surgery Safe?
Of the studies conducted on the efficacy of combining lap band revision and gastric sleeve, all of them point to the surgery as being safe and effective for long-term weight loss.
To be sure, Michigan bariatric surgeon Dr. Hawasli and his associates set out to determine the efficacy of the laparoscopic reversal of the lap band to the gastric sleeve.
Dr. Hawasli and his team followed 489 lap band patients over an eight-year period. Of those patients, 7% went on to have their lap bands reversed to the sleeve gastrectomy. The reasons for the reversal varied. Some experienced slippage, others erosion or infection, while a few were merely unhappy with their weight loss progress.
These patients were now free to experience the benefits of the gastric sleeve, such as satiation, lack of hunger, and the ability to regulate their eating without feeling deprived. Furthermore, unlike other bariatric surgeries that involve the rerouting of your digestive system, like the gastric bypass, the sleeve gastrectomy only involves the removal of part of your stomach. It will not affect other areas of your stomach or digestion, which means you are unlikely to suffer from nutrient-related losses or illnesses.
In fact, the gastric sleeve comes with few complication risks, except those that come with any type of minimally invasive surgery, such as infection, excess bleeding, and side effects like temporary bloating and indigestion, which usually pass before long.
Results of Dr. Hawasli’s Experiment
Back to Dr. Hawasli’s experiment. For the patients he was studying, the Lap-Band to gastric sleeve bariatric surgery procedure was not without complications. One patient experienced leakage due to band erosion and one a narrowing of the digestive passageways. Another was readmitted to the hospital for nausea and dehydration. These complications proved minor. All three patients were under treatment, and the entire group began losing rapid amounts of weight.
Dr. Hawasli’s conclusion is that gastric band removal to the gastric sleeve is safe and viable for long-term weight loss.
The doctor did recommend that patients who experience erosion or narrowing issues because of gastric band wait around six months to complete the lap band reversal with the gastric sleeve. This is known as a staged band reversal.
What is a Staged Lap-Band Reversal?
In some cases, such as if complications of Lap-Band are present, your doctor may recommend that you complete your gastric band reversal in stages. Common issues can include GERD (gastroesophageal reflux disease), food intolerance, band slippage, band erosion or port infection, esophageal dilation, and inadequate weight loss.
The typical waiting time between the lap band reversal and the gastric sleeve is usually six months, though your surgery could be scheduled in as little as three months following lap band removal. The break between surgeries allows your body to heal before the sleeve gastrectomy surgery.
What to Expect After Lap Band Reversal to Gastric Sleeve Surgery
After performing the gastric sleeve surgery, your surgeon will remove the tools from your abdominal cavity before sealing up the incisions. Afterward, you may have some swelling and feel some discomfort at the surgical treatment site. These issues should resolve on their own within a few days. At most, you could spend a day or two in the hospital before returning home. Expect to rest for around two or three weeks before returning to your usual routine. You should be back to work within days or up to a week following gastric sleeve surgery.
A Healthy Lifestyle is Key
Whether you wear the Lap-Band or have the gastric sleeve fitted, you will increase your chances of achieving your weight loss goals by living a healthy lifestyle. That includes eating lean meats, healthy carbohydrates, and plenty of vegetables. You can also be healthy by drinking adequate amounts of water, eating small meal portions, and engaging in regular exercise.
Your bariatric surgeon can give you direction on how to eat, what to eat, and when and how to exercise for maximum weight loss. You can also turn to your surgeon and the surgical team for help if you ever run into trouble. The nature of the gastric sleeve, and as a result of the small stomach pouch, you will already find yourself consuming smaller meals. You only need to fill your stomach with healthier food options. Accomplish that and healthy weight loss is right around the corner.
For Long-Term Weight Loss, Schedule a Consultation
Give the Lap-Band the boot and schedule a Lap-Band Removal to Gastric Sleeve Surgery instead. Experienced bariatric surgeon Dr. Moeinolmolki (Dr. Moein) is a Gastric Band Removal to Gastric Sleeve specialist. Call Dr. Moein and his surgical team to find an answer for your questions. You can also schedule a virtual consultation with Dr. Moein to see if this amazing weight loss surgery might be right for you. Call (310)694-4486 to learn more.