Bariatric Surgery Take 2 Converting Lap-Band to Gastric Sleeve

Bariatric Surgery Take 2 Converting Lap-Band to Gastric Sleeve

I admit that I’m a bit biased toward the awesomeness of gastric sleeve surgery versus other bariatric surgeries. I’ve seen the pros and cons of all different kinds of surgeries, and I’ve dedicated my professional career to gastric sleeve because I firmly believe it offers the best combination of safety and effectiveness. But my bias also exists because so many people who’ve had other kinds of bariatric surgery have asked me whether I can convert them to a sleeve instead.

 

The reasons they want a change are many, and I’ll get into those. But as to their question about the possibility of converting a Lap-Band into a sleeve, the answer, thankfully, is yes. 

 

What’s the Problem with a Band?

 

Here’s a shocker: I placed a band in my own mother in 2006. Back then, Lap-Band was considered the best bariatric surgery option, and everyone wanted one. That’s no surprise when you consider that it was marketed as a surgery that was reversible, adjustable, and minimally invasive. Lap-Band manufacturers sold surgeons like me on the idea that there was no need to cut into the patient’s stomach and no stomach stapling required—just a ring that’s placed around the stomach.

 

The reality? Not so great.

 

Eating is a minefield with a band. In fact, the first thing many band patients do when they go out to eat is look for the restroom because there’s a pretty good chance they’ll need to vomit before the night is over. We all know that healthy food is premium fuel for our bodies, but band patients have a lot of trouble with things like chicken and produce. Junk food is much easier for them to digest. But that stuff will kill you in the long run—literally. And puking on a daily basis? Um, no thanks.

 

Converting to a Sleeve

 

Not surprisingly, people who got bands back in the day have decided that it’s no way to live. And the good thing about a band is that it IS reversible. The reason these patients wanted bariatric surgery in the first place remains—they need it in order to lose weight permanently and live healthfully—so many want to convert their band into a sleeve.

 

These days, I do a lot of revisional surgery, which just means going from one procedure to another. And, yes, I did one for my mom. In fact, you can take a look at her story on our YouTube channel: www.youtube.com/endobariatric, go to playlist, and look for “Dr Alvarez’s Mom Journey.”

 

Can You Resleeve Me?

 

This is another question I get frequently. Patients who’ve had sleeves done in the past, usually by other surgeons, aren’t getting the results they want and ask me to “fix” it. I can, but only if the sleeve is really the problem. You see, the amount of food you can take in depends in large part on the size of bougie the surgeon inserts during surgery. I use a 32 Fr bougie because it’s been shown to deliver the best weight loss. But if you had a larger bougie, the size of your stomach is larger.

 

So there may be something “wrong” with your sleeve. But maybe not. Much of the time, it’s not the sleeve that’s malfunctioning—it’s the owner. Too many carbs and not enough exercise tend to be the biggest problems. That’s why I always suggest that patients get a barium sulfate solution test, complete with an endoscopy. Only after I review the results personally do I speak with patients about whether a resleeve would benefit them. I’ve turned so many patients down because nothing was wrong with their sleeves. The answer is a renewed commitment to healthy eating and activity, and we can help with that, too.

 

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