2nd time banders . . . what's that like?

I am here trying to learn from some of you who have been completely re-banded (total system).
1. How did that 2nd surgery exsperence go as compared to the first time
2. Has the 2nd band resulted in the same or different results
3. How long did you have the 1st band and how long since you have had your 2nd band
4. What is an Allergan-Inamed "case" all about? How does having them open a case matter? Did they benifit you in terms of cost of 2nd surgery or did they pay for the 2nd band? Did they send their Doctors to assist in the surgery? Did they help in other ways?
5. How long did you have to wait after the determination for the 2nd band and how much weight did you gain?
6. What did you do that really helped as you waited through this 2nd leg of your journey?

Your feedback last Wed. and Don Mills of Inamed have already made a great deal of difference cause the information was so timly. I can deal with most things if I have the facts to make informed decisions. I just need to be the one to make the call about my body and quality of life. I was not given that at my clinic on that day. I am sure I will try to have a 2nd band and I pray that it will workout for the long term.. But I have started getting control of my weight gain by getting serveral new tools (Diet Assistant 6.0 PDA& desktop SW and OTC appetite control pills) to hopfully help me stay focused. My goal is to go into January as healthy as I possible can by not gaining any more weight. This leak could not have happen at a better time of the year :faint: cause I truly believe the Lord is telling me to trust in Him and not my prosthetic. He is using this season to drive it home.

I just wanted to close and again thank those who replied to this post.

I'd like to hear from 2nd time bandsters too. I lost my band due to erosion, and have been slowly but steadily regaining weight ever since. I'd have to self-pay for another band, but I'm thinking it might be worth it despite the risks. Can anyone share their experiences the second time around?

PLEASE POST TO LET ME KNOW HOW YOU FEEL ABOUT YOUR 2ND BAND EXSPERIENCE. I NEED TO HEAR FROM YOU!!!!

I have been reading searching for others who have had their bands completely replaced. I am also facing this and would deeply appreciate hearing from others to know how you feel about doing so. Was it worth it in terms "pain for loss"? Have you had more complications? Are you doing well?

I am 30 mths from the 1st banding surgery and haveloved having my band. At 15 mths had to have 2nd surgery to fix a tube herna (poked up at bar line and became a problem). Also, the clinic has had on-going issues hot being able to get me to a substainable fill level in my Vanguard Inamed band....but in spite of all this I have lost (today) 71 lbs. and I'm around +28 lbs from my goal to get to 24 BMI.

So here it is the time of year where there is food everywhere and I have no band to guide me; I'll never make it through Thanksgiving and Christmas. So, what do you think; would you do it over again?

Thank-you,
Judy

Here's what I've read on the topic. MOST surgeons do not place a second band on someone who has experienced erosion with a first band. The logic behind that decision is that the best predictor of how a patient will react in the future is how the patient has reacted in the past.

The manufacturers of Midband agree with GeezerSue, they emailed me that I should seriously consider some other procedure as the risk of eroding a second time were higher for some one who'd eroded already. I'm heeding that advise, no second band for me... not worth it IMO.

As far as I can tell, nobody really knows what causes erosion. Some doctors think it's random luck, some think it's caused by overfilling the band, some have other ideas. I haven't been able to find a definitive reason, and my doctor doesn't know. I've found only one study, published June 2005 in Obes. Surg. In it 10 erosion patients were rebanded, and all were still successful 4 years later. Have never found a study of rebanded erosion patients losing the second band to erosion, but would really like to. It's hard making a decision this serious without complete factual information. The only reason I've heard to avoid rebanding is the possibility of thick scar tissue from the first band removal. If anybody can get more information, it would help a lot of us who are trying to decide what to do.

Luna Koi. . .I agree it would be helpful to have as much information as possible. Just to be sure I contacted my doctor's office today and they afirmed that my band only leaked at the band and there are no other signs in the radiology reports, x-rays, or contrast images of my Vanguard band having erosion or slippage. They said that was why I could wait till January to be scheduled. Still this idea about scar tissue is a concern.

From what I've seen in the literature, replacing a leaking band is generally a safe and successful procedure. I wish I shared your problem, instead erosion. The big area of mystery is the cause of erosion (which of course is nothing to do with your situation), and the outcome of re-banding. I've found several more studies in various medical journals that indicate re-banding is successful in Australia, Belgium and Israel. I haven't found any definitive studies one way or the other in the U.S. so far. It may be that the American doctors are cautious because it's a newer procedure in the U.S.

I would also be interested in anything you may find from others in this regard. c@vioclehighvalley.com

my sister had a band slip. They pulled it up . It happened because of throwing up so much. It was her gullbalder. They removed it. Her band it opened, not filled for months. At first she gained some. But as we all should watch what we eat she is loosing again. She was the first band they had slipped. I'm banded also loosing slowly but thats ok. Remember it's in our heads also to watch what we eat.

Erosion is serious business. Your stomach can be extremely damaged... it's not the same as a slip at all. Depending on the degree of an erosion, it can not only prevent a surgeon from placing a new Band, it can keep him or her from doing any revision surgery. It really depends a lot on how badly the stomach was damaged.

Personally, it would seem too risky to me. I'd look at other options. But here are some studies anyway...

Obes Surg. 2005 Jun-Jul;15(6):849-52.Links
Treatment of intra-gastric band migration following laparoscopic banding: safety and feasibility of simultaneous laparoscopic band removal and replacement.
Abu-Abeid S, Bar Zohar D, Sagie B, Klausner J.

Department of Surgery B and the Advanced Endoscopic Surgery Service, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Israel. dr_subhi@tasmc.health.gov.il

BACKGROUND: Intra-gastric band migration (band erosion) following laparoscopic adjustable gastric banding (LAGB) is a known complication requiring revisional surgery. Management has most often involved band removal and suturing of the stomach wall, followed by delayed replacement at a third operation. We report our experience with simultaneous band removal and replacement. METHODS: Between May 2001 and December 2003, we performed 754 laparoscopic operations using the Lap Band (R). Patients developing band erosion were treated by laparoscopic band removal and immediate replacement of a new band following gastric wall repair. RESULTS: 16 patients (2.1%) developed band erosion after a mean of 23 months following surgery (range 11-40 months). Patients presented with epigastric pain (6), port-site bulge (3) or were asymptomatic (7), band erosion being suspected during fluoroscopy for band adjustment and confirmed by gastroscopy. Postoperatively, 11 patients developed fever that responded to antibiotics. No patient suffered from intra-abdominal infection, wound infection, pneumonia or pulmonary embolism. Mean hospital stay was 4 days (range 1-8 days). CONCLUSION: Band erosion following LAGB can be treated safely with simultaneous laparoscopic band removal, gastric wall suturing and immediate replacement of the band, thereby preventing weight gain, the appearance of co-morbidities and the need for additional surgery.

PMID: 15978157 [PubMed - indexed for MEDLINE]

Obes Surg. 2003 Jun;13(3):435-8.Links
11-cm Lap Band System placement after history of intragastric migration.
Vertruyen M, Paul G.

Department of Laparoscopic GI Tract Surgery, Europe St-Michel Clinic, Brussels, Belgium. marcvertruyen@belgacom.net

BACKGROUND: Intragastric migration (erosion) of the band after laparoscopic adjustable silicone gastric banding (LAGB) is a serious late complication. It requires removal of the entire system. Subsequent recurrence of obesity can be treated by laparoscopic placement of a larger band: the 11-cm Lap Band System. METHODS: In 727 laparoscopic gastric bandings using the 9.75 Lap Band, 10 cases presented with intragastric migration of the band. The same complication was encountered in an additional 4 patients who had previously been implanted with an Obtech band in another hospital. Laparoscopic removal of the band was performed in all cases. In 9 cases, after a delay of 6 months, a new gastric band was placed using the 11-cm Lap Band, because of uncontrollable recurrence of obesity. RESULTS: No complication was observed during the laparoscopic removal of the system. The placement of a new band required conversion to laparotomy in 1 patient who had previously received an Obtech band which had been placed using the pars flaccida technique. After a mean follow-up of 21 months, no intragastric migration of the new bands was noted. CONCLUSIONS: Laparoscopic placement of an 11-cm Lap Band in patients with a history of intragastric migration is a safe procedure. It allows effective control of recurrent obesity. The laparoscopic procedure was easier in patients initially operated using the perigastric technique.

PMID: 12841907 [PubMed - indexed for MEDLINE]

Obes Surg. 2001 Dec;11(6):744-7.Links
Lap Band erosion: incidence and treatment.
Niville E, Dams A, Vlasselaers J.

Department of Abdominal Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium. erik.niville@ping.be

BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) is an effective and safe surgical treatment for morbid obesity. Migration of the band through the stomach wall is a well-known late complication that may jeopardize the aim of the treatment--permanent weight reduction. METHODS: 301 patients were followed for > or = 2 years (mean 39 months) after a Lap Band procedure. Cases of erosion were studied retrospectively. RESULTS: 5 patients (1.66%) developed erosions. Laparoscopic band removal was carried out in these 5 cases without complication. The first 4 have received a new Lap Band, and all are doing well. CONCLUSION: Band erosion is a bothersome late complication after LAGB and requires band removal. Rebanding is a feasible option. Further study and longer follow-up are necessary to determine whether these patients will develop erosion again.

PMID: 11775574 [PubMed - indexed for MEDLINE]