What Are the Causes of Lap-Band Slippage?
Lap-Band slippage occurs in approximately 2 percent to 18 percent of bariatric patients. It's defined as when the lower part of the stomach “slips” through the band, creating a larger pouch that balloons above the band. This complication can be alleviated by removing fluid completely from the band and allowing the stomach to rest in the hopes the slippage will fix itself naturally, but this method usually works with a minor or small slip. For major slips, surgical repositioning of the Lap-Band is necessary. Symptoms of slippage include vomiting and nausea, acid reflux or heartburn, and being able to eat larger portions because the stomach and pouch have stretched.
Perigastric Surgical Technique
Slippage happens either on the front or back side of the stomach. Posterior slippage commonly occurs when surgeons use the "perigastric" technique, which allows the back side of the stomach to slide up freely through the band. Today, most surgeons prefer the "pars flaccida" technique, developed to avoid posterior slippage. The pars flaccida technique results in a much lower rate of slippage, up to 16 percent less often. Anterior slippage can be prevented by the surgeon suturing the stomach below the band to the stomach above the band, which helps lock the band into proper position.
Overeating often leads to slippage. The band pouch stretches and grows as you eat and drink more than you should, meaning more than 1 cup chewed food per meal. At this stage if the pouch is only enlarged, the slippage can be mended by taking out all of the fluid to deflate the band, allowing the pouch to eventually go back to its normal size.
Fizzy or sparkling sodas and beverages are believed to cause slippage. The carbonation in diet and regular sodas or champagne and beer incites bloating and gas, which over time results in a distended band pouch. Bariatric surgeons usually advise avoiding carbonated drinks, but some allow on rare occasions a soda or bubbly beverage if you first let it sit until the bubbles dissipate entirely.
Overfilling the Band
Most surgeons recommend waiting six weeks before getting your first Lap-Band fill. Once you start filling the band with fluid, which causes restriction, proceed slowly and conservatively. Sneak up on reaching what is called your "sweet spot," which means the band is inflated to the point where a small amount of food per meal satisfies hunger for four to five hours. Overfilling the band until it's too tight can lead to food being stuck in the pouch, stretching out the pouch and causing band slippage.
Slippage can also occur if you eat too much and vomit frequently. When you gorge, food gets stuffed down in the pouch and sometimes even in the esophagus, causing nausea and then vomiting to rid the body of the offending food. Overeating, eating too fast and not chewing thoroughly usually leads to multiple vomiting episodes after meals, which increases the likelihood of a band slip.
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