DR C, Can you give us some pointer's about slips. Can you ever definitively say what caused it? Is is sometimes poor surgical technique and sometimes our fault for not getting an unfill when we need one, does excessive "PB'ing" contribute? This issue FREAKS us all out and we want to be compliant and do right things right. Help us out if you can. What advise can you give us?

I was banded last Nov by Dr. Ortiz and did not get a fill until late Jan. I was 9 weeks post op. Get my fills in Kansas City and have had 4 total. The only one that did not require an unfill was the first one. This isn't leading to a slip is it?

Thanks in advance for your help and time. You are a legend and an ICON to us bandters. :faint:

Kay

Hi Kay,

I am not Dr C, but I got this information from a doctors office regarding how to avoid complications after lap band surgery.

I am not sure if repeated unfills and fills are good, I have had saline removed my band only once, I am almost 1 year out. I doubt several unfills will cause a band slip, but repeated unfills is probably NOT good either. You probably need to find a common fill level you can live with, remember the band will NEVER do ALL the work for us. If we try to use that way, it can get us in trouble. Also if you have concerns call your doctor and schedule an Upper GI to make things are ok.

Hope this info is helpful

AVOIDING COMPLICATIONS AFTER LAP-BAND SURGERY

The most frequent, avoidable complications associated with the Lap-band are band slippage, stoma obstruction, esophagitis, and pouch dilation. These problems can be minimized with proper eating habits and close post-operative management and follow-up.

It is important for our patients to have a better knowledge of these complications in order for them to identify the symptoms and receive proper treatment immediately.

Band Slippage

Band slippage, also known as gastric prolapse, is part of the gastric fundus moving through the band, resulting in the development of an overly large gastric pouch. This leads to excessive stomach tissue inside the band and obstruction between the upper pouch and lower stomach.

It should be considered when patients who have had a normal postoperative evolution begin to experience changes in their eating ability (increased sense of restriction or obstruction).

Typical symptoms are increased difficulty in swallowing solid or liquid food, vomiting, pain after eating that lasts more than a few hours and reflux. The first response should be to deflate the band and give proper hydration. A barium swallow should be performed to determine the position of the band and to make the diagnosis of prolapse. If, in fact, the band has slipped, the treatment is to remove or reposition the band through laparoscopic surgery.

Stoma Obstruction

It is defined as the obstruction of the passage of food from the gastric pouch to the rest of the stomach and it is usually caused by food obstruction

Symptoms include pain while eating, chest pain after eating, inability to swallow solids (there is usually no problems when swallowing liquids) and nausea.

This is diagnosed through an upper GI study where the obstruction is directly visualized.

In these cases the band must be deflated and the patient should remain on a clear liquid diet until the symptoms have subsided.

Pouch dilation

This involves esophageal and gastric pouch reaction to restriction. It is associated with an overinflated band in an overeating patient and it may lead to more serious complications such as band slippage

The symptoms include lack of restriction after a tight fill.

It is most commonly seen in patients that have a tendency to binge or eat large quantities of food disregarding the feeling of satiety.

The treatment for this is to deflate the band for at least one month to give the esophagus a chance to go back to its normal size and after this has happened, start over with the fills gradually tightening the band and monitering the size of the pouch through upper GI studies.

How to Avoid This?

Before your surgery, you are instructed on how your eating habits must change. Chewing your food properly, eating slowly and avoiding the foods your body does not tolerate decreases the possibility of vomiting which is the main cause of band slippage.

Also I forgot to mention another thing, if your surgeon placed your band wrong in the first place, yes that can cause problems, you will know something is wrong, if you never have been able to tolerate many solids and vomit all the time even if you are following rules and eating slowly and chewing your food well. I would question if the doctor place the correctly.

But, if you are NOT following rules by chewing your food well and your band maybe a bit too tight to tolerate foods, YES this can lead to slippage if you vomit/PB daily.

Moving of the band is going to happen as the fat around the stomach disappears.(the layer of fat that is actually attached to the stomach)

:faint: Thanks NANA for the cool info. I really don't think I have a slip. I go back for a fill on 09-11 and right now I am tight in the morning, a tad loose at lunch and by evening very loose. I have never had any REFLUX but just wondered if 5 fill and 4 unfills = NOT GOOD. As soon as they do the unfill I can tell but it takes about 3 days for the swelling to go back down. Then gradually I can eat more and more and know I need a new fill.

Dr. Malley always reassures me and says we will find my sweet spot. I have accepted the part that breakfast and lunch will be tight to make me about right in the evening. Right now lunch is just right. So I think I know what my sweet spot will feel like but I may not have for 3 meals a day.

Thanks to all for the info.

If you had an early slip and never really had any trouble vomiting, it could be surgical technique. If you, like many bandsters, have had your share of PB'ing, there is no way to know.

The bottom line is - slips are rare in patients who don't PB. Proper eating techniques are very important!

Dr. C

Cincinnati, Ohio

www.TheBandDoctor.com 877.442.BAND

DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

I have learned to eat everything really slow and when I feel too tight I just go with Soup until I get an unfill.

Those creamy soup calories can add up so I would much rather be adjusted correctly so I can get my Protein down.

DR C -- Thanks Again for all you do for us bandsters. You sure have earned your golden crown for answering all our questions.

My band is probably fine and some of my fellow bandsters have had unfills but not as many as me. The more I read the more educated I get and then sometimes the more I read the more paranoid I get! I will keep you all posted after my next fill. I will visit a little more with the doc and see what he thinks. It seems as if I react to the fill every time and my stomach swells and then once it is grumpy there is nothing to do but unfill.

Kay