By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    bowl of vegetable salad
    Raw Foods: benefits and harms
    November 9, 2021
    pros and cons of the keto diet
    Read This Before You Follow the Keto Diet
    May 18, 2022
    spinal cord injuries
    4 Potential Causes of Spinal Cord Injuries (and How to Seek Compensation)
    May 25, 2022
    Latest News
    Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
    May 16, 2025
    Learn how to Renew your Medical Card in West Virginia
    May 16, 2025
    Choosing the Right Supplement Manufacturer for Your Brand
    May 1, 2025
    Engineering Temporary Hospitals for Extreme Weather
    April 24, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    4 Reasons Why Medical Device Compliance Matters
    May 22, 2020
    What To Know About The Importance Of Healthcare Marketing
    November 23, 2019
    healthcare courses
    6 Supplemental Courses in Healthcare to Support Your HR Degree
    August 20, 2021
    Latest News
    Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
    May 18, 2025
    The Critical Role of Healthcare in Personal Injury Recovery: A Comprehensive Guide for Victims
    May 14, 2025
    The Backbone of Successful Trials: Clinical Data Management
    April 28, 2025
    Advancing Your Healthcare Career through Education and Specialization
    April 16, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: The Lap-Band: Operation is easy, aftercare is critical
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Technology > The Lap-Band: Operation is easy, aftercare is critical
Technology

The Lap-Band: Operation is easy, aftercare is critical

DrTerrySimpson
Last updated: May 12, 2013 6:15 am
DrTerrySimpson
Share
9 Min Read
Lap Band
SHARE

There is one thing clear about Lap-Bands: it is taking care of the patients after surgery, teaching them how to use the band, that is critical in how it is used. There have been a number of reports in the literature about centers that have removed bands, didn’t have the results with the bands that many others have reported, and felt that their results with the band must be global results.  Those results are in stark contrast to Lap-Band surgeons who use the band a lot, who have great results with their patients, who see their patients often.

There is one thing clear about Lap-Bands: it is taking care of the patients after surgery, teaching them how to use the band, that is critical in how it is used. There have been a number of reports in the literature about centers that have removed bands, didn’t have the results with the bands that many others have reported, and felt that their results with the band must be global results.  Those results are in stark contrast to Lap-Band surgeons who use the band a lot, who have great results with their patients, who see their patients often.

The reason for this is simple: those who do not know how the band works, those who do not use the band that often, should not be offering the band as a weight loss procedure. What is even more sad is some of those individuals who have undergone lap-band surgery and develop a band slip, are having their bands removed and being converted to a gastric sleeve (where 90% of the stomach is removed).  Those patients are being told that the band didn’t work for them, that they failed the band, or the band failed, and that this is the best result for their obesity.  Many of those patients have had long-term success with the band.

When a band is first placed in the top part of the stomach you can see a normal appearing x-ray. The key to teaching patients about how to take care of the band is to enforce that the band is NOT ABOUT RESTRICTION. The band does not, and should not restrict food going past it. Instead the band should allow food to go freely past the band. If food stays above the band too long, it will become uncomfortable. Ultimately this causes stretch with the stomach on top of the band and begins a process of dilation and as the stomach above the band dilates, it begins to pull stomach from below up to the band.

More Read

Image
Telemedicine Coming Soon to a Pharmacy Near You: HealthSpot
SolveBio Scores $2M to Clean Up and Index Genomic Data for Developers
How Can Technology Play a Role in Addiction Treatment?
Surgery Trumps Intensive Medical Therapy for Obese Diabetics
The Top Trending Health Care Apps In 2020

Once this happens there is what is called a band slip.  It is at this stage that some surgeons mistakenly remove the band and convert patients to a gastric sleeve. Converting to a sleeve in these circumstances comes with a 5.5% leak rate- meaning, it is far more deadly.

There are two alternatives, however.  One alternative is to remove all the fluid from the band and place the patient on a strict liquid diet for a week.  Recheck an x-ray and often times the band will be back in a normal position. During this time the patient needs to be educated about how to use the band, and not use the band. Behaviors that cause slips include: relying on the band to feel full, eating too fast, getting foods stuck too often. The most deadly is relying on the band to make a person feel full.  If they do this, they will cause the stomach above the band to stretch, as it stretches stomach is pulled from below the band to above the band and result in a slip.

The second alternative is a surgery to unbuckle the band.  This takes the pressure off the upper stomach.  There is scar tissue from where the band and the stomach were and that scar tissue must be opened up.  This is a quick operation, takes about ten minutes, and allows the person who could not eat or drink to immediately be able to.  Then, in two months the patient has a choice to have the band re-buckled, leave it alone, or if they wish to go to another weight loss operation there is much less risk of a leak. We have done over 20 patients with unbuckling the band, and later repositioning it. All with great results, no morbidity or mortality in that group.

The key, however, is having a band surgeon who knows how to take care of the band, and not a surgeon who is quick to abandon the band and not wish to teach the patient how to use it.

Here is the problem with the gastric sleeve: it will stretch over time. Having done hundreds of sleeves, after four or five years we see that they stretch, and sometimes will stretch back to the size of a normal stomach. That same behavior that caused the stretching of a pouch above a Lap-Band will ultimately lead to stretching of the sleeve — then the patient is faced with another choice.  A number of my patients who underwent duodenal switch, or gastric sleeve, years ago and had their stomachs stretch, have had the lap-band placed over them, with great results.

Great results are not from the procedure: it is from teaching patients about aftercare and lifestyle.

That is the key to having success with the least invasive operation. Not that there are not complications with surgery- as there are with any operation – but it is quite clear: there is a huge difference in the results of those who have a band done from a center where they specialize in the band and the aftercare of the patient, and those centers where they offer a band but are quick to abandon it.

Lap Band

The lap band is placed at the top of the stomach – here is a diagram of the band placed in its normal position

Band x-Ray
This is a normal band x-ray. The band is the faint outline in a 8oclock to 2 oclock position, there is normal contrast going through it.
Band Slip
Relying on food to go slowly through the band, and having the band too tight means food stays above the band. Some people say this makes them “feel full” but it ends up causing a band slip
Total Slip
Once there is enough stomach above the band, it flops over the band – like a muffin top. At this point patients experience heartburn, reflux, sometimes night cough
Band slip x-ray
The x-ray shows the band now in a 10 oclock to 4 oclock position, with the stomach pulled above the band, and the muffin top
Unbuckled band
Here is a diagram of an unbuckled band. Below the band, on the stomach is the scar tissue which must be lysed (or cut) to allow healing

 

TAGGED:bariatric surgeryLap-Bandobesity
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

Do You Grind Your Teeth at Night? Here’s How Night Guards and TMJ Treatments Can Help
Do You Grind Your Teeth at Night? Here’s How Night Guards and TMJ Treatments Can Help
Dental health
May 21, 2025
The Secret To A Confident Smile: Top Tips For Better Teeth
The Secret To A Confident Smile: Top Tips For Better Teeth
Dental health
May 21, 2025
Clinical Expertise
Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
Health care
May 18, 2025
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Health
May 15, 2025

You Might also Like

Image
Health ReformNewsPolicy & LawPublic HealthWellness

Should We Tax Fat?

June 1, 2012

Top 10 Health Technology Hazards For 2013

November 7, 2012

Rare Diseases and the Promise of Genetics [VIDEO]

May 2, 2014

Technology, Healthcare and the Frankenstein Syndrome

April 11, 2012
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?