The lap band is a device used to help patients use weight. It is an adjustable silicone band that is surgically placed around the stomach to restrict the amount of food the patient can consume. The surgeon can inflate the band by injected saline into it through a port that lies beneath the skin. That way, the band can be adjusted to provide just the right amount of restriction.
The lap band can be a very effective tool for weight loss, but it does carry the risk of a number of complications. One potential complication is slipping of the band. Sometimes the band actually slips out of place, but in other cases part of the stomach slips up under the band. Lap band slippage can be a very serious problem, depending on the severity of the slip. In mild cases, fluid is simply withdrawn from the band, the stomach is allowed to heal for several weeks, then the band is refilled. In more severe cases, another surgery is required so that the band can be repositioned or removed.
According the maker of the lap band, 24% of patients experience some degree of slippage. A slipped lap band can be caused by a number of things, and it is impossible to prevent slippage altogether. However, there are some things that can be done to help prevent the problem.
Surgical Technique
There are different surgical techniques used to place the lap band. The technique that was common in the past is known as the perigastric technique. With this technique, posterior slippage, or slipping in the back of the stomach, was common. Today, most surgeons in the U.S. use the pars flaccida technique, which greatly reduces the risk of slippage.
Doctors usually use sutures to hold the band in place, and some doctors use more sutures than others. Using too few sutures or not placing the sutures correctly can cause a slipped lap band.
Eating Habits
After lap band surgery, patients are given a specific diet to follow. The post-op diet varies slightly from doctor to doctor or from dietician to dietician, but in general patients are first started on full liquids, then moved onto pureed foods, then soft foods, then finally allowed to resume a regular diet. This progression usually takes several weeks. Advancing the diet too quickly can damage the pouch that is formed above the band and cause slippage.
Eating too much at one time can also stretch the pouch and cause slippage. Patients should be given specific instructions about the proper portion size and they need to measure their food and eat only the specified amounts.
Vomiting
Excessive vomiting can cause the lap band to slip. It is sometimes impossible to prevent vomiting, of course, but there are some things patients can do to reduce the risk. Overeating can cause vomiting after lap band surgery, so again, patients need to measure their food and eat only the recommended portions. Not chewing well can also cause vomiting. If patients experience any significant nausea, they should contact their doctors and ask for an anti-nausea medication.
Sources:
Lap Band System. http://www.lapband.com/get_informed/about_lapband/risk_information. Risk Information.
AllAboutLapBand.com. http://all-about-lapband.com/problems/slippage.html. Lap Band Slippage.
