Baba Wawa

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.

Over

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 The balloon is withdrawn upward until it is against the gastroesophageal junction (Figure 7).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

Yes, sales fell from $240mm to $160mm, a huge decline! Sort of backs up what being said, AGBs are going the way of the dinosaurs, due primarily to high failure/complication rates + high follow up costs.

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.

Are you suggesting that there is no new information now vs 2009? There's a ton of people who are experiencing exactly what I am. I don't have bad energy...I don't like it when people who are suffering are blamed for it. As obese/formerly obese people we should be able to show some empathy. A lot of obesity is rooted in psychological problems, abuse and self esteem issues...now we're going to blame these people for a medical device's inherent propensity to fail AND cause permanent damage to vital organs?!! Heartless and cruel is the only way to describe this sort of attitude. I don't care if you're following the thread. If ONE person opts out of banding because of the information I posted, my job is done. As far as your character assessment of me, you could not be more wrong. Responsible is my middle name. I'm fully responsible for my decisions and accepting of the consequences AND appreciate the good my band has done me...when you know better you do better. We know better now, the newer WLS candidates can avoid the pitfalls, injuries and pain of band complications that happen even if you follow all the rules (which by the way are so inconsistent from one doctor/clinic to the next, who the hell knows what they are?). You go ahead and believe what you do....I really don't give a rat's behind. I would post links, but LBT won't allow. Anyone who would like more info, please pm me.

Realize bands are not filled at surgery, allergan recommends a primer fill of 3cc at surgery for its bands...not really a lot, but it often has to be removed before discharge.

Thread...you can eat that? This is what they are stating as fact. My disagreement is with the stance that they are blaming people who fail, across the board. One poster even quoted that 90% of failures are due to noncompliance. Most erosion is caused because people eat things they are not supposed to and eat too much. It puts pressure on the band and causes it to erode. I think that most band failures are because of the patient. Being too tight and throwing up, eating too much, drinking carbonated beverages and caffiene, these all cause erosion. The amount of people on here that do all these things will end up with getting their bands removed. It's not worth the risk to over eat. You have to take some responsibility in your diet. People say nothing is off limits but if you're eating something that is constantly getting stuck then that product shoud be off limits.

You might be a bit tight...failure to lose, maladaptive eating go hand in hand. Try getting a little unfill and you might be able to eat the way you're supposed to...

The issue with broccoli is volume. Broccoli has a lot of Protein per 100 calories, but you'd have to eat almost 4 cups to equal 100 calories. 1 cup chopped broccoli is 29 calories and 2.5 grams protein. 2 oz sirloin steak has 14 grams protein and is 110 calories and is within our volume limits 1/2 to 1 cup food per meal. There are other sources of dense protein if you have trouble with meat. String cheese, eggs, tuna salad, cottage cheese, Greek yogurt are some options. I mix 1/4 kashi go lean crunch with 6 oz Dannon light and fit vanilla NF Greek yogurt....15 gr protein, which is my meal goal. I also find that if I'm making meat loaf, I add a bit of olive oil, ff Greek yogurt (plain), eggs to my 93% lean beef, + a bit of old fashioned oats and ground veggies. It's delish, you can make meatballs out of the same recipe. The meat is more moist, softer, but is still dense protein.

My guidelines for nutrition are: 60+ gr Protein per day Avoid processed carbs 64 oz Water daily Eat protein first, veggies second, carbs only if there is room, usually not room. 3 meals per day, 15 gr protein, 20-30 gr low glycemic carbs 1 snack, 15 gr protein, usually a bit of tuna salad or a couple of RF string cheese or ff Greek yogurt. Avoid liquid calories I have problems with greens, so try to eat colorful crunchy veggies, like peppers, carrots, cabbage, onion, asparagus, etc. Meal size per my nutritionist is 1/2 to 1 cup... No drinking for 30 min after eating With an empty band I've lost 15 lb in 3 months.

Yep it does.... http://www.lapband.com/en/live_healthy_lapband/months_beyond/

There seems to be a prevalence of opinion in another thread that Lapband failure is due to noncompliance 90% of the time. What do you think? I know I am compliant, but I'm too tight, even with an empty band. Please share your story here. Thanks!