Getting the lap band after bypass (band over bypass) might seem like a strange thing to do. After all, gastric bypass is considered the much more effective option for surgically assisted weight loss. However, some patients can benefit from gastric banding even after they have undergone bypass. This is becoming an increasingly common form of bariatric surgery revision.
Who Is a Candidate for Band Over Bypass?
This procedure is designed to assist patients who have plateaued in their weight loss without achieving their goal weight and those who have substantial weight regain. These are not uncommon problems, especially in patients who are at the top of the BMI range (50 or higher). Such issues may occur for a number of reasons:
- The reduced stomach pouch may not have been made small enough during the initial surgery.
- The stomach may have enlarged over time, permitting unintentional overeating.
- The opening from the stomach to the intestine may have widened, leading to reduced feelings of fullness after eating.
- The intestinal tract may have adapted to the bypass and begun absorbing nutrients more effectively.
If weight loss has stalled or substantial weight regain is occurring after a couple of years of initial weight loss, patients may wish to explore the option of having a band installed to jumpstart weight loss once again. However, patients who are regaining because of failure to comply with their diet and exercise regimen after gastric bypass are unlikely to have success with banding.
Benefits of Lap Band after Bypass
The lap band is a minimally invasive and reversible weight-loss surgery. This bariatric surgery revision is less risky than revising the bypass or converting it to a duodenal switch. The stomach pouch and intestines are not cut or rearranged in any way (an approach that can be risky due to the presence of scar tissue). Instead, an inflatable silicone band is placed around the stomach pouch, restricting the flow of food into the lower portion of the stomach. The band helps patients regain the feeling of fullness with small meal portions that they experienced after their original bypass procedure.
For patients who comply fully with their dietary plan, the results can be excellent. They may begin to lose weight again and be able to keep it off more easily since the band is adjustable. Pressure on the stomach can be increased or decreased without additional surgery to help patients maintain the ideal level of appetite control.
Important Facts to Know About Lap Band after Bypass
Although gastric banding is a fairly straightforward procedure for most patients, the risk of complications may be much higher for band over bypass. The stomach has already been operated on before, making it potentially more vulnerable to damage. It is important to choose a surgeon who has experience with bariatric revision surgery to reduce risks.
Weight loss tends to be slow and steady with the band. This is very different than the rapid and dramatic weight loss achieved immediately after gastric bypass surgery. Patients must remain committed to eating a diet consisting of small meals low in sugar and fat if they wish to be successful in losing more weight.