Lap-Band removal is an operation, usually done laparoscopically through small incisions, to take out the band, its tubing, and the access port. People have it because of a complication, because the band no longer controls their weight, or because they simply no longer want it. In Rancho Cucamonga, it starts with an evaluation of your history and tests, and a talk about removal alone versus removal with another procedure.
Why a band is removed
The FDA labeling calls the band a long-term implant and tells surgeons to advise patients that removal and replacement surgery "may be indicated at any time." It also names situations where removal may be needed or required:
- Erosion, where the band works its way into the stomach wall. The labeling says reoperation to remove the device is required.
- Slippage that does not settle when the band is emptied, or a blocked outlet that does not respond to deflation.
- Esophageal dilation (a stretched esophagus) that does not resolve after the band is loosened.
- Infection of the band or port, where the labeling says removal is indicated.
- Not losing enough weight, or simply not wanting the band anymore. The NIDDK notes that a surgeon may remove a band that causes problems or is not helping you lose enough weight.
Our guides to Lap-Band erosion and Lap-Band slippage describe the symptoms of each.
The evaluation before removal
Removal is usually a planned operation, so there is time to find out exactly what is going on first. The visit covers why you want or need the band out, your weight history, any reflux or swallowing trouble, and what you hope happens to your weight afterward. Common tests include an upper GI x-ray (you swallow liquid contrast while x-rays show the pouch and band position) and an upper endoscopy (a thin camera passed through the mouth to look at the esophagus and stomach). Endoscopy is the usual way to find erosion.
The answers shape the plan. A band with a mechanical problem in someone who has kept their weight steady may simply come out. A band removed for weight regain is often replaced in the same operation, or later, by a sleeve or bypass. Our page on removal alone versus removal with conversion covers that choice, and the Lap-Band revision page explains the wider options.
How the operation is done
The FDA labeling explains that the band is usually surrounded by a thin, clear capsule of scar tissue. Through a laparoscopic approach, or an open incision when needed, the surgeon cuts open the capsule, unlocks the band, and takes it out. The FDA patient guide says that if the band was placed laparoscopically, it may be possible to remove it the same way, and that an open procedure is rarely needed.
The operation is done at a hospital where Dr. Davtyan has surgical privileges, and the office will tell you which one. Whether you go home the same day and how much time off work to plan are details the office will confirm with you, because they depend on your health and on whether anything else is done in the same operation. Expect general anesthesia, and arrange for someone to drive you home.
What happens to your weight after removal
Without the band, the restriction it provided is gone. Studies of removal without a second procedure have found that many people regain weight. In one study of 41 patients published in Obesity Surgery in 2009, average body mass index (BMI) rose from 29.4 at removal to 36.7 over the period without a band or second operation, which averaged about 2.8 years; 5 patients (12.2 percent) kept their weight steady.
That does not mean removal alone is wrong for everyone. It does mean having a plan for weight afterward, whether that is a structured diet and activity program, medication, or a later procedure. The ASMBS Revision Task Force review found that evidence generally supports further treatment for persistent obesity and complications, while noting that complication rates are usually higher after reoperative surgery than after a first operation.
When to call
Call the office
- You want to discuss removal, or your band has stopped working.
- Reflux, food sticking, or night cough that keeps returning.
- Port-site soreness without fever.
Go to an emergency room or call 911
- You cannot keep liquids down, or you vomit blood.
- Black stools, severe chest or abdominal pain.
- Fever with redness or swelling over the port.
Frequently asked questions
Can a Lap-Band be removed if I am pregnant or planning a pregnancy?
Pregnancy on its own does not usually mean the band must come out. The FDA labeling lists pregnancy as a situation where the band may be deflated, so you can eat enough, and it can be refilled later. Whether removal is needed is a separate decision, based on whether the band has a complication. Tell the office early if you are pregnant or trying to be.
Can my band be taken out without another weight-loss operation?
Yes. Removal alone is an option, and some people choose it, especially when the band causes symptoms but their weight has stayed steady. Because studies show many people regain weight after removal alone, it helps to decide beforehand how you will manage your weight, and whether you might want a sleeve, bypass, or medication later.
How long after removal could I have a sleeve or bypass if I want one?
Some surgeons convert in the same operation; others remove the band first and do the second operation later, once the stomach has healed. The choice depends on the reason for removal, the condition of the stomach, and the procedure planned. Our guide to one-stage versus two-stage conversion explains the evidence on each approach.
Do I need to stop eating solid food before the operation?
Most bariatric operations come with a short preparation diet and fasting instructions before anesthesia, and the details vary by surgeon and procedure. The FDA labeling notes that a liquid diet before band surgery may shrink the liver and make the stomach easier to reach. Follow the written instructions the office gives you rather than general advice.
Talk with Dr. Davtyan in Rancho Cucamonga
Dr. David G. Davtyan, MD, FACS, FICS, FASMBS, is a bariatric surgeon who also offers revision surgery, gastric sleeve and gastric bypass, so removal and any next step can be discussed in one consultation. Call 909-355-2525 or 877-9-BE-SLIM (877-923-7546), visit 8330 Red Oak Street, Suite 201, Rancho Cucamonga, CA 91730, or use the contact page. The Rancho Cucamonga Lap-Band guide has more on living with and deciding about a band.
Sources
More in the Lap-Band in Rancho Cucamonga guide
Start at the Lap-Band in Rancho Cucamonga page, or go straight to a topic.
Understanding your band
Weighing your options
Getting care in Rancho Cucamonga
