Adjustable gastric band was the most popular weight loss surgery until year 2011. In 2008 about 14000 gastric bands were implanted in Australia which accounted for 94% of weight loss surgeries performed that year. How ever at present less than 1500 bands are implanted a year and the numbers are declining. This is mainly due to long term failure and complications compelling a high proportion to have revisional surgery.

When to consider a revision of gastric band

You may consider gastric band removal and another weight loss surgical option due either for failure of the band or due to a complication of the band. Failure of weight loss and weight regain are common long term issues after gastric band.

Quick Info

  • Failure of weight loss and weight regain are common long-term issues after gastric band.

  • Common complications lead to symptoms of over restriction.

  • Although the band can be removed, the stomach will never come back to its original condition.

Common complications lead to symptoms of over restriction. Gastric band slippage usually lead to night time symptoms including reflux, regurgitation, cough, aspiration and vomiting after meal. Reflux is also a common problem after gastric band which can lead to dilatation of the oesophagus and disruption of the lower oesophageal valve mechanism that prevents reflux. Rarely band erosion and device leak and port problems also leads to further surgery.

Gastric Band was marketed as a safe, effective and an easily reversible procedure. Although the band can be removed, the stomach will never come back to its original condition. The band device exerts pressure on the stomach which responds by making a thick capsule. Presence of a foreign body and stitches that keep the band in place, also lead to additional scaring. The result is a stomach with a variable degree of wall thickening that increases the risk of further surgery, particularly the risk of leak after resection surgery involving stapling through this area.

Gastric band removal surgery is a laparoscopic operation and requires general anaesthesia and an overnight hospital stay. This surgery involves dividing the sutures that keep the band in place and removal of the band, the tubing and the attached port. It is expected to have a variable amount of scar tissues around the gastric band that can make the operation difficult. It may also be necessary to divide scar tissue to allow the best chance for the stomach to expand, which can add to the risk of perforation and bleeding. Even after careful preparation of the stomach at gastric band removal, it may never recover to become normal again which increases the risk of revisional surgery. To minimise this risk, it is advised to allow the stomach about 3 months of healing time before considering having revision surgery.

At WA Weight Loss Centre, for privately insured patients with an appropriate level of cover, gastric band removal surgery carries no out of pocket cost.

Despite best efforts to maintain or lose weight, most if not all patients who had a gastric band removed, will experience regain of weight over the next 1-2 years. Due to this reason, many believe it is inadvisable to only remove the LAGB without performing an additional bariatric procedure, when deemed technically feasible and safe.

Gastric sleeve or various types of intestinal bypasses, are considered stronger weight loss operations compared to a gastric band, and are suitable options after band removal. Many complex and subtle patient related and previous operation related factors, influence the best choice of revisional surgery.

If you have/had a gastric band and are considering revisional surgery, Dr. Werapitiya is happy to assess you and guide you to the best option.