Lap Band Slippage - Symptoms, Diagnosis, Treatment

A condition in which sometimes the stomach wall can slip through the band resulting in lap band slippage.  This slipping will result in a bulge above the band.  Sometimes this will resolve itself, others it will be more severe and have side effects such as nausea and making it harder to eat or drink.  The following pictures depict a normal and a slipped band.

Normal Lap band on left.  One with Slippage on the right

Two common types of slippage:

Anterior slippage: the front of the stomach slips past the band. To try to secure the band at the time of installation, the stomach on either side of the band is stiched together trapping the band.

Posterior slippage: the rear of the stomach slides up through the band. This type of slippage was more common in the early 90's in Europe because they used the perigastric technique. Since then they've moved to the method employed in the U.S. and now commonly accepted as safe, the pars flaccida method.

Diagnosis of Band Slippage:  How can you tell?

Usually it's fairly simple to diagnose. If a patient has had no problems for a period of time and suddenly has acid reflux or if you can eat more than before with a tight band it may mean that the small pouch has been stretched by overeating and some of the stomach has pulled through the band. An x-ray with barium easily confirms the issue.

• As stated earlier, nausea or difficulty eating may accompany slippage.  The only sure way to tell is to visit your doctor and have an upper GI series x-ray.

Treatment of Band Slippage:

• Mild slip: Deflate the band; reinflate in one to two weeks.
• Moderate slip: Deflate the band, operate to reposition band.
• Severe slip: Deflate band and operate to remove band.
• Less than five percent of patients will require removal or reoperation
• In extreme cases the stomach above or within the band may need to be removed.

Prevention of Band Slippage:

• Appropriate band placement by surgeon
• Careful progression of diet by patient.  Follow your meal plan to a "T" No solid foods for 4 weeks.
• Wait at least 6 weeks for first adjustment.
• Avoid vomiting or purging
• Avoid over eating and stretching the stomach pouch
• Chew food slowly and completely