I hear it from prospective VSG patients all the time: lap band seemed like a good idea at the time, but it hasn’t helped much. And in some cases, it’s actually hurt their health. We talk a lot about patients having bariatric surgery in Mexico for the first time, but I do a fair amount of revision surgeries—meaning patients who’ve previously had a gastric band but want to switch over to vertical sleeve gastrectomy. If you’re considering it, here’s what you should know.
It’s not for losing those last 20 pounds
If you had success with a band but have regained a bit or haven’t quite gotten to your goal weight, a revision isn’t the way to get the scale moving. Every VSG procedure, whether it’s for a newbie or for a revision patient, is reserved for high BMI patients. A BMI of 30.1 to 40 is considered obese, with 40-plus considered severely obese. For perspective, that’s a six-foot-tall man who weighs 230 to 300-plus pounds. And that’s a 5’4” woman who weighs 180 to 240-plus pounds. Of course we evaluate every patient individually, but those numbers give you some idea of our basic parameters. If you’ve had bariatric surgery in the past and are wanting to trim off a few pounds, my advice is the same as for my VSG patients: go back to basics. More water, protein and produce first, and increase your exercise. Keep a log of everything you’re eating—a phone app is really handy for this—so you can analyze patterns. It’s likely that you’re simply eating too much of the wrong things.
It might improve more than just your weight
If you’re truly a candidate for a band-to-VSG procedure, you’re probably in for an overall boost to your health. The truth is that some bariatric surgery, as well as some surgeons, don’t do your body any favors. I see it all the time in the operating room. Many of my revision patients report not only losing the weight they’d hoped to lose, but other improvements to their wellbeing. Says Amber, “I was a revision from the band, and after yo-yoing with that for 10 years, my metabolism was shot.” A self-proclaimed “slow” loser after her VSG, she also had to get her mind right along the way. But she’s now on a path that feels great. “This. Tool. Works. The caveat is you are in control of how successful you are capable of being,” she says.
Another of my revision patients, Ellen, lost 75 pounds but found just as much joy in what else she lost. “The best part is no food intolerance, no acid reflux, no nausea, no vomiting, no being “stuck” or “sliming” or any of the horrible pain from my lap band,” she says.
It might take two procedures
Sometimes, I’m able to do a band-to-VSG revision in just a single procedure. But when it’s not safe—whether because of the amount of scar tissue or extreme fatty liver—I remove the band in one procedure and create a sleeve down the road when it’s safe to do so. Unfortunately, it’s fairly common for band patients to have a fatty liver and scar tissue. The tissue I’m working with must be strong enough to handle staples; if not, you’re at greater risk for leaks. And my patients’ health is just not something I’m willing to gamble with. Even if you need two procedures, though, it’s well worth it. “I had the band for 11 years,” says Tina. “Dr. A removed the band, and then I came back after I was all healed to do second surgery. Best decision EVER; I love my sleeve.”
If you’re considering a band-to-VSG revision, our staff is happy to walk you through the procedure and answer any questions you have.
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“Changing lives…one sleeve at a time”.
