Will Your Lap Band-to-Gastric Sleeve Revision Require Two Surgeries?


After making the decision to get vertical sleeve gastrectomy, most patients want to have it done now, now, now! I get that. It’s exciting to think about all of the wonderful ways your life will change with VSG. But if you already have a lap band, things get a bit trickier. Is it possible? Absolutely! But it might require two surgeries for that conversion.

What is a revision surgery?
When it debuted years ago, Lap Band (or adjustable gastric band) seemed like an ideal solution to obesity. It was a minimally invasive procedure that, as the name implies, was adjustable as a patient journeyed through the weight loss process. It worked for some people; for others, it negatively impacted their quality of life in a big way. Band infection and erosion, food intolerances, ongoing reflux, and inadequate weight loss are just a few of the side effects. Not surprisingly, I’m frequently asked to do revision surgery, which involves removing the old Lap Band and performing a vertical sleeve gastrectomy in its place.

Why can’t both steps be completed at the same time?
They can. But not for everyone. There’s no way to know the condition of a patient’s stomach until we get into the surgical suite. It makes sense that the people who want revision surgeries are the ones experiencing complications, right? So we often find scar tissue from the bands, as well as patients with fatty livers because the adjustable gastric band didn’t lead to sustained weight loss. Either of these things can lead to a two-step process, wherein we remove the band in one surgery and do VSG in a second procedure a few months down the line. Believe me, I understand that patients want to get it all done at once, which is why I offer one-step surgeries whenever possible. But the most important thing—what I’ll never compromise on—is my patients’ safety. Sometimes waiting is the only way to get the best, most successful outcome.

What should patients do while they wait?
If you wake up to the news that our team was only able to remove the old band, we’ll make sure you have an individualized plan for moving ahead. But in general, here are some things you might expect:

  • The urge to eat. Even if the adjustable gastric band didn’t do its job well for you, there was still some restriction in place. When that restriction is gone, many patients feel like they can eat and eat and eat. And some do, gaining a lot of pounds while they wait for the next step. That can hinder our ability to do the VSG, so this “meantime” requires some discipline.
  • The need to diet. It stinks, but it’s likely the truth. Sometimes when we’re in there for the band removal, we’ll find an extremely fatty liver, which makes VSG dangerous. So while you wait for your body to heal, you’ll also be asked to lose some weight to get your liver in optimal shape. Again, we’ll give you precise instructions and equip you with a plan to help you reach those goals.
  • Better quality of life. If you’re getting a revision because of how the Lap Band affected day-to-day living (as opposed to inadequate weight loss), you’ll notice pretty quickly that you feel a lot better. A little while after I removed Becky’s band, she said, “I haven’t puked in one month and two weeks!” If you have to wait on gastric sleeve in Mexico, at least you’ll do it without the vomiting, nausea, heartburn, reflux, and difficulty swallowing that may have become part of your daily life.

If you’re ready to exchange something that isn’t working for a tool that’s been proven effective for tens of thousands of my patients alone, get in touch with Endobariatric today.

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“Changing lives…one sleeve at a time”.