Gastric band removal
Whilst some patients have had excellent results with Adjustable Gastric Banding, unfortunately, side effects and complications are becoming increasingly common.
Revisional surgery is complex surgery and expertise is required to carry out the procedure as safely and effectively as possible.
Management of gastric band reversal
Gastric band reversal or revision needs to be carefully managed. If you choose to undergo additional bariatric surgery, it is best to do this over two separate procedures.
Ideally we would recommend these two separate bariatric procedures to be carried out at least three months apart. The main reason for this is that the band will have significantly scarred the stomach (like a bacon rind in thickness) and this is difficult to staple. Think of trying to staple cardboard rather than paper. After at least three months the scarring softens (the bacon rind renders) and so stapling is much more reliable and less likely to leak.
An uncomplicated removal of a gastric band usually entails an overnight stay in the hospital only. You should be discharged eating a normal diet and requiring paracetamol or equivalent analgesia only. You should refrain from driving until you deem yourself not impaired from the keyhole surgery. Unless you have an abdominal hernia or specific weakness in your abdominal wall you should be able to return to most activities including work within a few days. You may need additional workplace clearance for commercial driving. Always check before your surgery.
Gastric band removal
Gastric banding was a popular procedure however the gastric band may require advanced surgical skills to remove if it is eroded, infected or has slipped.
Why might I need my gastric band reviewed?
Is gastric banding reversible?
"The good news is if problems do occur, gastric band removal is generally possible. Whether this is technically reversible is debatable. If your thoughts of reversibility is that it can be removed without there being any indication it was there, then this is not reversible. That’s because a gastric band is a silicone band around your stomach.
As a result, it doesn’t change your anatomy but there will have been a foreign body reaction causing scarring. It will have squeezed the nerves lying on the stomach. It will have subjected the valve at the junction between the oesophagus and stomach to increased and abnormal pressures and it will have stretched the upper stomach or oesophagus. Some of these effects may be  permanent. When you visit our practice we’ll discuss these effects and the most suitable revision options with you."
The side effects or complications indicating that your gastric band is failing or needs revision may include any of the following symptoms or signs:
- Reflux, Regurgitation, Vomiting
- Inability to eat normal healthy foods
- Maladaptive diet
- Adjustments always too loose or too tight
- Infection
- Blockage/Leakage
- Pouch Dilatation
- Slippage/Migration
- Erosion/Perforation (effect will be permanent)
- Oesophageal dilatation (may be permanent)
- Oesophageal motility issue causing difficulty or pain on swallowing (may be permanent)
- Aspiration into chest causing pneumonia and/ or lung abscess
Revisional surgery is complex surgery and expertise is required to carry out the procedure as safely and effectively as possible. The body reacts to foreign materials including Gastric Bands by surrounding it in a thick fibrous capsule of scar tissue.
In addition there may be dense adhesions especially if there has been a previous major complication such as erosion/perforation or slippage and strangulation of the stomach.
The surgeons at Upper GI West have extra gastro oesophageal and advanced laparoscopic training so your surgery and management will be in expert hands. We have been trained to optimise your treatment and are skilled to manage and treat any complications both laparoscopically and endoscopically if or when they occur.
These revision operations can take many hours to perform accurately and so we will not perform more than 2 on a whole day’s operating list. Remember it is the accuracy of performance of the surgery that is the greatest variable in its functional outcome and hence your potential for weight loss.
As we are also fully credentialed Endoscopists, we usually also take the opportunity to endoscope you on table under the same anaesthetic as your band removal to exclude any internal band related issues such as an erosion and to fully assess and clear the stomach to prepare for further upcoming surgery.
Who will perform your bariatric surgery?
Experience has shown that gastric band removal and/ or revision needs to be carefully managed. Revision options may include:
- Repositioning or replacement of Gastric Band or its port
- Removal of Gastric Band with no further surgery
- Removal of Gastric Band with conversion to another weight loss procedure
"Where a conversion to another type of bariatric surgery is needed, we recommend two-stage operations. In fact, doing both at the same time has higher risks. It also compromises the effectiveness of the revision. Best practice is to carry out the gastric band removal then wait three months before further surgery. This allows scar tissue to soften and reduces risks.
We believe the new surgery will also be more effective this way because a more accurate and uniform pouch or sleeve can be created when the scarring has softened. With a more accurate and uniform pouch or sleeve comes better function and optimal outcomes."
Other types of weight loss surgery
A plan for further surgery should have been discussed with you before removal of your gastric band unless you have specifically only requested its removal.
It is possible that diet and exercise may be enough for you but if you previously had a BMI of 35 or 40 your statistical chance of losing your weight and keeping it off without further surgical intervention is one in 20 and one in 200 respectively.
There are multiple options for further revision bariatric surgery which include:
- Sleeve Gastrectomy
- Roux-en-Y Gastric Bypass
- Single Anastomosis Gastric Bypass
- SIPS/SADI Duodenal Switch
Your Surgeon can discuss the pros and cons of each these options and help make the most appropriate choice based on your individual circumstances.
Key Points
What is the cost of gastric band removal?
The Surgeons at Upper GI West do not charge an out-of-pocket gap for any gastric band removal. We will change your Health fund and Medicare directly. It is recommended that you check your level of cover with your Health Fund.
You may have an anaesthetic gap and you are advised to check with your health care fund for any additional fees you may incur.
If we performed your original bariatric procedure your Surgeon will not charge another out-of-pocket gap for additional revision procedures.
If we perform your band removal your revision surgery gap fee will be significantly lower than if another surgeon has already removed your band.
Why choose us for your surgery?
Revisional surgery by definition is more complex and difficult to perform. More time and planning is required. Accuracy of the creation of the revision procedure pouch or sleeve is the most important factor determining function. Function is the most important determinant to outcome.
We at Upper GI West will take time working you up for your surgery. We will explain and have a plan for your future treatment.
We will use the skills gained from additional years of oesophago gastric training to perform your surgery expertly and prepare the stomach for revisional surgery as well as assessing the stomach endoscopically.
We will support you psychologically, medically and dietetically through your journey and we will perform any additional related surgery without further gap charges (other than the gap for the revision itself) should any be required.