Can I Have Gastric Sleeve Surgery if I’ve Already Had a Gastric Band?

The adjustable gastric band, often called the lap band, was a common weight-loss operation in the 2000s. Many people who had one have since found that it stopped working, or caused problems. If that is you, you may wonder whether another operation is still possible. In many cases, the answer is yes.

How a gastric band works

A band is a silicone ring placed around the top of the stomach, creating a small pouch above it. A thin tube connects the band to a small port under the skin, so it can be tightened or loosened with fluid. The aim is to make you feel full with less food.

Why bands often stop working

The risk of problems around the time of band surgery is low. Over the years, though, many people have trouble with their band:

• The band slips, or wears into the stomach wall (erosion).
• The port or the tube leaks or breaks, so the band loses its fluid.
• The pouch above the band stretches, or swallowing becomes hard.
• Reflux, vomiting or food getting stuck.
• Weight loss that stalls, or weight that comes back.

In a long-term study from Belgium, about 60% of people needed another operation 12 or more years after their band, and nearly half had the band removed. A large US study found that people had lost on average about 12% of their starting weight five years after a band, compared with about 19% after a sleeve.

Canadian guidelines now suggest that bands not be offered, because of their long-term complications and results. In the US, bands make up well under 1% of bariatric operations today. In line with these guidelines, 360 Sleeve does not recommend a gastric band.

Converting a band to a sleeve

In a conversion, the surgeon removes the band and its port, frees the scar tissue around the stomach, and makes a sleeve. It is usually done laparoscopically, through small incisions.

Often the band comes out and the sleeve is made in the same operation. Sometimes, for example when the stomach wall around the band is inflamed or damaged, the band is removed first and the sleeve is made a few months later. A review of studies found similar safety for the one-step and two-step approaches when each was chosen carefully. Your surgeon explains which suits you.

Removing a band on its own, without another procedure, often leads to weight coming back. That is one reason many people choose a conversion.

What to expect

• A review of your records, and often an upper endoscopy or imaging to see how your stomach looks today.
• A more complex operation than a first sleeve, because of scar tissue. Complications are generally more common after a revision than after a first operation.
• Weight loss that can be somewhat less than after a first sleeve, and that varies widely from person to person.
• The same eating stages, daily vitamins and follow-⁠up as after any sleeve.

A sleeve, or another option?

A sleeve is not the only choice after a band. Some people are better suited to SADI-⁠S or a gastric bypass, for example if they have significant reflux or type 2 diabetes. Your surgeon goes through the options that fit your history, including the ones we do not offer.

What to bring to your consultation

• The operative report from your band surgery, if you have it.
• When the band was placed, and how often it was adjusted.
• Any recent endoscopy or imaging reports.
• Recent bloodwork and a list of your medicines.
• Your weight story since the band, in your own words.