Hi,

I was banded 09-07-06. Since I had 4 fills and I have not lost weight since november 2006. At first I thought that I was on a "plateau" but at the second fill I was told that 30% of fill was missing. The PA filled the band to its previous level and added more... Then at the third fill 60% of liquid was missing (minus 2.5cc) in 4 weeks.

Two weeks later I was at the hospital for a check-up with contrast. The band was fill with contrast and all the system was checked under x-ray and the result was: NO LEAK. However, at that time I had lost 25% of previous fill... just 2 weeks before :cake: .

I asked the PA explanation about the missing liquid but was told that there was none at this time and that we will check again in 4 weeks. :omg: :girl_hug:

So my question is: Does anyone had similar experience? Does anyone have answer about that loosing fill but no leak situation ?

Thanks and ciao... for now.

There have been a few studies published that show that the Band's membrane is semi-permable and so losing fills over time is normal. I had this problem, and Dr. Rumbaut filled me with a solution different than saline... which solved the problem.

From the May 2005 issue of Obesity Surgery

Permeability of the silicone membrane in laparoscopic adjustable gastric bands has important clinical implications.

* Dixon JB,

* O'Brien PE.

Australian Centre for Obesity Research and Education, Monash Medical School, The Alfred Hospital, Melbourne, Australia. john.dixon@med.monash.edu.au

BACKGROUND: The single most important attribute of the laparoscopic adjustable gastric band (LAGB) is its adjustability. Having the correct volume of Fluid within the band is crucial for optimal performance. We observe a small reduction of the satiety-promoting effect with time. The characteristics and clinical relevance of volume change have not been adequately investigated. METHOD: One observer measured the saline volume within the 10-cm Lap-Band in 118 consecutive patients who fulfilled the entry criteria. The same observer had performed and recorded the previous adjustment. Initial volume, final volume and time between observations provide the data for analysis. In addition, a range of adjustable gastric bands currently available were bench-tested to assess broad applicability of findings. RESULTS: The difference between observations varied from 0.0 ml to -1.0 ml, median of -0.1 interquartile range (IQR) 0.0-0.2 ml. Two factors were associated with volume change: time in days between the observations (r = -0.55, P<0.001) and the initial volume within the band system (r = -0.50, P<0.001). These two independent factors accounted for a significant proportion of the variance observed (Cox and Snell R2 = 0.45, P<0.001). Replacement of any discrepancy appears to maintain effectiveness. All six bands showed similar saline loss when bench-tested. CONCLUSION: Adjustable gastric bands are semipermeable, leading to a small reduction in saline volume with time. Patients should be informed of this effect, attend for regular follow-up visits and seek help if the band's effectiveness appears reduced. We recommend that the volume present should be checked and readjusted at least every 6 months.

PMID: 15946451 [PubMed - indexed for MEDLINE]

And from an earlier study in European Radiology from 2001

pontaneous volume changes in gastric banding devices: complications of a semipermeable membrane.

* Wiesner W,

* Hauser M,

* Schob O,

* Weber M,

* Hauser R.

Institute of Diagnostic Radiology, University Hospital Zurich, Switzerland.

The goal of this study was to prove that adjustable laparoscopic gastric banding (LAP-BAND) is semipermeable and that luminal adjustment with saline leads to spontaneous fluid loss, luminal widening, and effect loss which makes repeated readjustments necessary. In 64 patients stoma adjustment was performed with saline according to the guidelines of the manufacturer (group 1). In 32 patients hyperosmolar contrast material was used for stoma readjustments with the intention to detect a system leakage after spontaneous fluid loss and spontaneous luminal widening was observed (group 2). After spontaneous luminal narrowing had occurred in group 2, all patients from group 2 and all additional patients (n = 148) underwent stoma (re-) adjustment with iso-osmolar contrast material (group 3). Spontaneous fluid changes which led to spontaneous changes of the luminal width were then analyzed for the different filling substances in each group. Fifty-two patients from group 1 presented with effect loss because a spontaneous luminal widening had occurred secondary to a fluid loss of 0.1-0.2 ml/month. All 32 patients from group 2 presented with increasing obstruction and food intolerance because a spontaneous luminal narrowing had occurred secondary to a spontaneous fluid gain of 0.1-0.3 ml/month. In our patients from group 3, where stoma adjustment was performed with iso-osmolar contrast material, no spontaneous fluid changes were observed and luminal width/degree of obstruction did not change. The LAP-BAND is semipermeable. Stoma adjustment should not be performed with saline in order to avoid spontaneous luminal widening and the need for repeated readjustments. Stoma adjustments with hyperosmolar contrast material are clearly contraindicated since osmotic fluid gain leads to increasing obstruction. Stoma adjustments should be performed using iso-osmolar filling media which provide a stable luminal obstruction.

PMID: 11288845 [PubMed - indexed for MEDLINE]

Bea, if he can't get the whole 2ccs out you definitely have a small leak. He can fill you with a solution which is thicker than saline to help. Its like fixing a flat tire. I would try that. I worked for me and I've held my fill for 2 months now. Good luck.

I would say if you have a problem, you shouldn't have to pay....doesn't make sense..I've had insurance pay on all of mine though, so I am not an expert at that. Do you have health insurance? I'm going through a crazy issue too...now they're telling me I'm a mystery..no leak, no slip, it just doesn't work??? What the heck? So I'm going back to my original surgeon to see if he can figure it out. It's crazy....but I do know there's something wrong...it just doesn't go from working to not....doesn't make sense.

I had my fill removed for pregnancy and have had two fills since after birth and now I am at 2.3 without much restriction.... Anyone else have this issue? My last fill before pregnancy was 2.7 with a large restriction.

I really don't want much more to be replaced, it makes my stomach hurt when I wear a bra alittle on the tight side. It also makes me have to push it (my bra)out when I eat,, so the food can finish its path. Odd huh?

Bra shopping time!

Also, it hurts like crazy when my daughter, 4, leans on my tummy or chest after dinner. OUCH! :omg:

TY,

J

I'm curious too...If you have problems or complications from this procedure, (being a self-pay) are the complications covered by insurance?

Just ask him to fill you with Omnipack. It's thicker. Try the easiest solution.....

I'm curious too...If you have problems or complications from this procedure, (being a self-pay) are the complications covered by insurance?

Depends on the complications and the insurance company.

My doctor says insurance will always cover problems. I don't know if it has to do with the way they code it or what.

did he charge you for the fix in your kink and how much ?

I am having this trouble too. I had a fill on Wed. and it feels like I have less restriction than I started with. It does get really expensive with all the tests that have to be done to find out if you have a leak.

That twist in the tubing is interesting. I would hate for my doctor to tell me everything is there when he pulls it out, yet it's not getting to the band.

He is always telling me I read too much stuff on here.

I had my lapband done on 9/24/07. I lost 30 lbs in the beginning due to swelling, but as time progressed I felt no effect at all and steadily gaining back the weight. I went yesterday and the NP told me she pulled back 4 cc and put 9 cc in and there was no effect whatsoever. I paid cash for the procedure and it seems that the doctor has no liability for their actions. So now I am facing a possible revision. They are thinking that there is a leak at the port. I have never been so disappointed in my life. It took a lot for me to have this procedure at my age. Jeannette