The adjustable gastric band, commonly known as the Lap Band, is a surgical weight loss device placed around the upper stomach. This device restricts food intake and slows the passage of food, promoting a feeling of fullness after eating small amounts. Band slippage is a serious complication where the stomach tissue moves relative to the band. Because this displacement is a mechanical failure, waiting for the issue to self-correct is not a safe or viable option and demands immediate medical attention.
What Lap Band Slippage Means
The Lap Band is intended to sit snugly at the uppermost part of the stomach, creating a small gastric pouch above it. Slippage occurs when a portion of the stomach below the band herniates or bulges upward through the band’s opening. This leads to proximal pouch dilation, significantly distorting the stomach’s anatomy. The overall rate of band slippage is reported to be between 4% and 13% of cases over time.
The physical displacement can happen in two primary ways: anterior slippage, where the front wall moves upward, or posterior slippage (prolapse), involving the back wall. Common factors contributing to this movement include persistent, excessive vomiting, eating too quickly, and poor adherence to dietary guidelines. Slippage may also be related to the original surgical technique, such as insufficient fixation of the band or placement that is too low on the stomach.
Recognizing the Urgent Symptoms
Identifying Lap Band slippage quickly is important because the condition can lead to severe complications if left untreated. The most common symptom is the sudden onset of severe difficulty swallowing, medically termed dysphagia. This sensation often involves food feeling stuck immediately after eating.
Patients also frequently experience persistent, severe heartburn and acid reflux that does not respond to standard medication. Other signs include nausea, frequent vomiting of undigested food, and sometimes a complete inability to keep food or liquids down, indicating an obstruction. These symptoms indicate a mechanical problem requiring immediate evaluation by a bariatric specialist.
Can Lap Band Slippage Resolve Without Intervention?
The answer to whether Lap Band slippage can resolve on its own is definitively no. Since slippage is an anatomical problem where a part of the stomach has physically moved through the band, the body cannot spontaneously reposition the organ. Trying to manage the slippage with only dietary changes or by waiting is dangerous.
The slipped stomach tissue is at risk of being pinched off by the band, which can cut off blood supply. This lack of blood flow can potentially lead to tissue death (necrosis) or perforation. Immediate contact with a bariatric surgeon is required to prevent these life-threatening complications, as the underlying mechanical problem remains until intervention occurs.
Medical Fixes and Long-Term Management
The first step in addressing suspected slippage is a prompt medical evaluation, typically including imaging tests like an upper gastrointestinal (UGI) series or a CT scan. The UGI series uses X-ray technology to observe liquid flow, helping determine the extent and nature of the slip. Once slippage is confirmed, the initial intervention is usually the emergency deflation of the band by removing the saline solution from the device.
This deflation is a temporary measure designed to immediately relieve pressure on the slipped stomach tissue and alleviate symptoms like obstruction and pain. After the immediate crisis is managed, definitive treatment options are considered, which are almost always surgical. For small or early slips, a laparoscopic procedure may be performed to manually reposition the stomach and secure the band’s position, though recurrence is common.
The most common long-term solution, especially for recurrent or severe slippage, is the surgical removal of the Lap Band. Following removal, patients often undergo a revisional procedure after healing, such as conversion to a Sleeve Gastrectomy or Gastric Bypass. These alternatives are generally more reliable and have lower complication rates than the band itself. Adherence to post-operative diet and lifestyle changes is paramount after any fix or revision to prevent future complications.