disadvantages / complications
In today’s society, food is consumed at a fast pace and the volume of food is larger. Learning to change every single aspect of how you eat, the speed at which you eat, and what you eat is difficult. Mastering the proper eating techniques is extremely important with the Lap-Band.
The stomach area above the Lap-Band is not intended to hold or store volumes of food. If the opening where the band is around the stomach is blocked the food cannot easily pass through this area. This blockage is known as “sticking” or “getting stuck.” Getting stuck will not stop you from breathing. You will experience mid sternal discomfort. Depending on which eating technique or techniques that were not followed will determine the degree of discomfort you will experience. Do not drink anything, as this will only cause more discomfort.
You must stop eating food immediately. Stay calm. Sit up straight or, even better yet, stand up. Casually walk around and let gravity help the food move down. Try not to throw up or vomit. If the food still does not move through the Lap-Band area, the esophagus and stomach will produce a fluid to lubricate the area which will help the food move downward or upward.
Getting stuck causes an irritation to the inside lining of the stomach where the Lap-Band is. Do not continue eating more food. You will need to allow the stomach time to heal from this irritation (swelling). Frequently we ask of patients to return to only clear liquids and protein drinks for a few days, and then progress to soft, moist foods prior to returning to solid foods. Occasionally you may need to have some fluid removed from your Lap-Band by one of our team members to help decrease this irritation (swelling).
The Lap-Band is the safest of the bariatric surgeries. It is however not without potential risks. The immediate surgical risks include a mortality rate of 0.03%. The cause of death can be from injury to the esophagus or stomach, pulmonary embolism, heart attack, or anesthetic complications.
Band Erosion (1%)
Erosion of the stomach lining under the Lap-Band can cause part of the Lap-Band to erode into the stomach. Symptoms: pain in the epigastric area, port pain, eating larger amounts of food, becoming hungrier after meals, potentially gaining weight, little or no restriction with adjustments. Diagnosis: EGD (upper endoscopy) Treatment: surgical removal of the Lap-Band to allow the stomach tissue to heal
Leakage of the fluid (normal saline) can occur at any place within the Lap-Band system. Most often, the leak is located at the tubing as it passes into the abdominal cavity due to wear and tear. Symptoms: eating larger amounts of food, becoming hungrier after meals, potentially gaining weight. Diagnosis: notice a difference in the amount of fluid that is found in the Lap-Band system and what is expected.Treatment: surgical replacement of the port and adjacent tubing, or if needed, surgical replacement of the entire Lap-Band system
Band Slippage (3%)
The Band itself does not slip, the inside of the stomach slips up through the Lap-Band. Cause: excessive overeating and or vomiting Symptoms: reflux or heartburn, night time coughing, regurgitation, difficulty swallowing food/fluidsDiagnosis: Upper GI X-ray or EGD (upper endoscopy)Treatment: depending on the degree of slippage, you may need to have surgery to reposition or replace the Lap-Band.
Esophageal Dilatation (up to 10%)
Esophageal dilatation can occur due to several factors. A band that has been adjusted too tight can lead to dilatation of the esophagus. If the band is adjusted appropriately, the leading cause of esophageal dilatation is drinking fluids too fast. While most patients learn to eat slowly, many patients tend to drink liquids quickly. The band will not allow for rapid transit of liquids if it is adjusted properly. Before fluids back up, the esophagus will dilate. The dilatation can occur over time, and may not be associated with any symptoms. To prevent this common problem, you must learn to drink fluids slowly, at a rate of one ounce every 5 minutes, or 12 ounces per hour.