Baba Wawa

It's an ill-conceived, dangerous surgery that is irreversible after 2-3 weeks, can cause gastric necrosis and can only be revised to a pouch. Not recommended by many.

I agree that the 4cc band study is irrelevant, but your statement " Just because half the Lap Band patients are messing up their own bands with their own ignorant behavior isn't a reflection on those who actually follow the rules and do the right thing." is just unkind, and arrogant. As stated before, if you're so happy with your band and complication free, why are you here on the complications forum? What scares you about someone posting this information? If its irrelevant, readers can do their own research and figure that out. There's a wealth of information available today vs several years ago, when many of us were banded. I'm sorry, but there are just too many variables within the banded community; the patients, doctors, hospitals, clinics, etc all have variables. Doctors protocols are very different in their dietary requirements pre and post op. There are huge differences in pre band testing requirements, screening for ability and willingness to comply. Some band mills took advantage of people, taking their money, operating on them and charging exorbitant fees for follow up....and many of those patients have had complications and or failure to lose due to incompetence on the doctor's part. Imagine that this OP is someone you care about, is truly struggling and looking for real support...few of the responses on this thread meet that need.

Since you are full for 4-5 hours and losing 3 lbs per week, you are in the green zone. Go slow on the fills...being too aggressive with fills can bring problems. Congrats! Keep up the positive attitude!

Good advice from 2muchfun, make an appt with your nutritionist, stay with your food plan and take charge of this situation. It is important to continue with the positive band habits since without fill, you are more prone to a slip if you over eat, take too big of bites, etc. Good luck and keep us posted!

Great Post! When our body and the band are "in sync" it's a wonderful thing. I appreciate that it helped me to stick to my food plan by keeping me satiated to the point I have to remind myself to eat, sometimes. Though my band and body are out of sync right now, I still follow my food plan, whenever possible. With no fill, I still have restriction, and at times have difficulty with many foods. That said, I've lost 17 lbs since my unfill 7 months ago. I hope to be able to keep my band, my doctors and I are working on a solution to my problems. It is a choice, by taking ownership, we empower ourselves to succeed.

Since this is a complications forum, you're going to see negative posts. It seems to me that the OP had her band surgery with a band mill type of operation. I was fully informed prior to my surgery, but still have major complications, even though I was and am completely compliant. Stuff happens, bands DO fail, sometimes people fail, but you're reading a post complications forum...it's unreasonable to expect to find positive posts here.

Thank you! I am following up with my gastroenterologist next month. Will post as things evolve.

Nana, sorry you got hammered. Apparently there are some who reside on this site who have nothing better to do than add insult to injury. PM me if you would like a link to a group that will actually support you.

...

Thank you!

Thank you for understanding the purpose of my post. I'm sorry you're going through this, too. My reflux came on strong after my unfill too. I'd wake up choking on acid, horrible way to exist. In addition to dealing with my motility issues, I've had influenza A and B plus a stomach virus in the last 5 weeks. My immune system is really run down and I think stress and the fact I only can eat properly about half the time aren't helping. Hope you find some answers! Let me know how your doctors appt goes! We have a Failed Bands group on FB, let me know if you want to join. The admin is very knowledgable about revision surgery and the kind of problems we've been having.

Have no idea who the OP is...this site seems very hostile, though and a bit paranoid. Jean knows me...

Thanks...I've had very negative experiences here and on another site in the past when I share my negative experience...that's why I said that. I love my band, my GI doc thinks it just aggravated a preexisting condition. I don't love how I feel right now.

Like I told Cheryl, I didn't ask for help, I'm sharing my story. That's what this forum is about, right.

FU

No problem...just didn't want those who know me on this site to become alarmed

STFU

MYOFB

Prolapse is where the stomach slips upward and a portion of it hangs over the band, creating a pouch that may not empty...you can imagine how decaying food in this second pouch can cause major problems.

I'm sorry, but I don't think accusing the OP of being a troll, guessing at her secret identity and generally putting her down is a positive reflection on this forum. It is a Complications forum, isn't it? I know who you might be referring to, and she isn't even a member of this site. This smells of Internet bullying to me.

Thanks Cheznoel, but I didn't lose my husband, my father in law.

I'm so tired of never knowing what foods I can eat...puking up stuff. This is no way to exist. Ready to just throw in the towel and be done, just get this thing out of me!

The Lapband doesn't have "sharp" edges...I would ask discretely for your surgical reports/videos. Damage can be done to the stomach/band at surgery, if its not installed properly. Unfortunately, when we are self pay, the focus is on price rather than experience especially with the band since its marketed as "safe". With your issues early on with the band, I'm suspicious that you had a band and/or stomach that was damaged. Port pain is indicative of a leak somewhere in the system, subsequent infection and erosion. This isn't your fault. Implantation instructions for Lapband from Allergan's website:http://www.allergan.com/assets/pdf/lapband_dfu.pdf to expose the esophageal hiatus, the anterior stomach, and lesser omentum. Measurement of the Pouch: The anesthesiologist passes the calibration tube down into the stomach and inflates its balloon with 25 cc of air (some surgeons prefer saline). The balloon is withdrawn upward until it is against the gastroesophageal junction (Figure 7). Introduction and Placement of the Band: The inflatable band and Access Port are flushed with sterile saline (see “Band Preparation” and “Access Port Preparation”). The band is introduced into the abdomen via a 15 mm or 18 mm trocar. The band is pulled, end plug first, into place around the stomach with the instrument previously placed through the retrogastric tunnel (Figure 11). The tubing is inserted into the band’s buckle. The band is locked in place using atraumatic graspers. CAUTION: Failure to use an appropriate atraumatic instrument to lock the band may result in damage to the band or injury to surrounding tissues. Opening or Unlocking the LAP-BAND AP® System: The LAP- BAND AP® System provides for the re-opening of the band in the case of slippage or malposition. With atraumatic graspers, stabilize the band by grasping the ridge on the back of the band. Figure 12. Unlocking the LAP-BAND AP® System With the other grasper, pull the buckle tab up (see Figure 12) and slide the tubing through the buckle until there is ample area to adjust the position of the band. CAUTION: Failure to create a new tunnel for the band during repositioning may lead to further slipping. retention Gastro-gastric Sutures: Multiple non-absorbable sutures are placed between the seromuscular layer of the stomach just proximal and distal to the band. Sutures should be placed from below the band to above the band, pulling the stomach up over the band until the smooth surface of the band is almost completely covered. The tubing and buckle area should not be included in the gastro-gastric imbrectation (Figure 13). Ridge Tab Figure 7. Calibration Tube balloon withdrawn upward against the gastroesophageal junction This permits correct selection of the location along the lesser curvature and into the phrenogastric ligament to perform the blunt dissection (Figure 8). Figure 9. Dissection of the lesser curvature Under direct vision, the full thickness of the hepatogastric ligament is dissected from the gastric wall to make a narrow opening. The posterior gastric wall should be clearly recognizable. The dissection should be the same size as the band or even smaller to reduce the possibility of band and/or stomach slippage. Dissection of the Greater Curvature: A very small opening is created in the avascular phrenogastric ligament, close to the gastric wall at the Angle of His. retrogastric Tunnel: Always under direct vision, blunt dissection is continued toward the Angle of His until the passage is completed (Figure 10). Figure 8. Calibration Tube balloon and dissection point selected Lesser Curve Dissection Options recommended Technique PArS FLACCIDA: Dissection begins directly lateral to the equator of the calibration balloon in the avascular space of the Pars Flaccida. After seeing the caudate lobe of the liver, blunt dissection is continued under direct visualization until the right crus is seen, followed immediately by the left crus over to the Angle of His. The PArS FLACCIDA technique is recommended as it is the most widely used method for laparoscopic adjustable gastric banding and results in a reduced incidence of gastric prolapse and pouch dilatation compared to the PErI-GASTrIC technique (described below). Alternate Techniques PErI-GASTrIC: Dissection starts directly on the lesser curve at the midpoint (equator) of the calibration balloon. Dissection is completed behind the stomach toward the Angle of His under direct visualization, taking care to avoid the lesser sac. retro- gastric suturing is an option (Figure 9). PArS FLACCIDA TO PErI-GASTrIC: Dissection begins with the pars flaccida technique (above). A second dissection is made at the midpoint (equator) of the balloon near the stomach until the peri-gastric dissection intercepts the pars flaccida dissection. The band is then placed from the Angle of His through to the peri-gastric opening. Figure 10. Posterior instrument passage WArNING: Do not push the tip of any instrument against the stomach wall or use excessive electrocautery. Stomach perforation or damage may result. Stomach perforation may result in peritonitis and death. WArNING: Any damage to the stomach during the procedure may result in erosion of the device into the GI tract. CAUTION: Do not over-dissect the opening. Excessive dissec- tion may result in movement or erosion of the band. A blunt instrument is gently passed through the retrogastric tunnel. Figure 11. Placement of the band Figure 13. Suturing the greater curvature over the LAP-BAND® System and pouch Access Port Placement and Closure: The band tubing is brought outside the abdomen and is connected to the Access Port. The port is then placed on the rectus muscle or in an accessible subcutaneous site. The tubing may be shortened to tailor the position of the port to the patient while avoiding tension between the port and the band. The two components are joined with the stainless steel tubing connector. Ligatures may be 10

FYI, as reported in the NYT: As Sales Fall, Allergan Seeks a Buyer for Lap-Band By ANDREW POLLACK Allergan said Tuesday that it was looking to divest itself of its Lap-Band, the once-popular weight-loss device that has experienced several years of falling sales, loss of market share and controversies about its safety and effectiveness. The falling sales “do not fit the profile of a high-growth company like Allergan,” David E. I. Pyott, the company’s chief executive, told analysts Tuesday morning on a call announcing the company’s third-quarter financial results. In an interview, Mr. Pyott said Allergan had already hired an investment banking firm, which he would not name, and was sending letters to other medical device companies and private equity firms seeking a buyer for its obesity business, which also includes a balloonlike device that is not approved in the United States but is used in some other countries. The Lap-Band, a silicone ring that is wrapped around the stomach and can be inserted in an outpatient procedure, once appeared to have a bright future as a less drastic, if less effective, alternative to gastric bypass, which involves rerouting the digestive tract. But Allergan’s obesity business sales have fallen from a peak of $296 million in 2008 to an expected $160 million this year. In the third quarter, the sales fell by 25 percent to $37.4 million from a year earlier. The obesity business, while still profitable, represents less than 3 percent of total product sales for Allergan, which is known most for its Botox treatment for wrinkles, migraine headaches and other conditions. Although one-third of American adults are obese, the number of weight loss surgeries in the United States — about 160,000 a year — has stopped growing, largely because of the economy, Mr. Pyott said. Many patients pay out of pocket for weight loss surgery, and even when the procedure is covered by insurance, there can be a co-payment of thousands of dollars. Mr. Pyott said Allergan had made progress in the last year in lowering barriers to insurance coverage, but it was not sufficient to reverse the decline in sales of the Lap-Band. But gastric banding has also lost market share among weight loss surgeries, falling to about one-third from 44 percent a year ago, Mr. Pyott said. Lap-Band has most of the market among bands, although Johnson & Johnson also sells such a product. Gaining in popularity has been sleeve gastrectomy, which involves cutting out part of the stomach. It is considered midway between banding and bypass in terms of both effectiveness and the degree of invasiveness of the surgery. Dr. Marc Bessler, director of the center for metabolic and weight loss surgery at Columbia University, said that Lap-Band had lost some luster among bariatric surgeons because studies suggested it was not effective in the long run for one-third to two-thirds of patients. “You had data coming out that 10-year outcomes are not what we were expecting,” Dr. Bessler said. One study in Europe, for instance, published in The Archives of Surgery last year, reported that over 12 years, 60 percent of patients needed another operation, often to remove the band, because of complications or lack of weight loss. Allergan has said that techniques have improved since the patients in that study received their bands. In 2011, Allergan succeeded in getting the Food and Drug Administration to approve use of the Lap-Band for patients with lower weight than had been previously required. But that did not bolster sales, in part because of difficulty getting insurance to pay. The company dropped efforts to get the Lap-Band approved for use in teenagers after controversy arose about the product’s safety. There have been news reports about problems, including deaths, from the band. Allergan said its overall product sales for the third quarter rose 6.1 percent from a year earlier to $1.39 billion. Earnings per share, after adjustments, rose to $1.06 from 92 cents.