Without giving the details of the possible long-term
complications of the lap-banding and their causes, here are the most important
options that are currently available. Sometimes there is no formal consensus on
the choice to be made. Each single case should be thoroughly discussed with the
medical team:
- 'Conservative treatment': The principle of restriction by the same band is
maintained, either without operation - through the adjustments, deflating the
band slowly or rapidly, preferably under radiological control, for instance in
case of oesophageal dilatation -, or through a re-operation that keeps the same
band but fixes a slippage (repositionning of the band).
- Changing the band:
The principle of the band is maintained as well, but it is changed or replaced.
The reason may be a leak or a deficiency.
- Band removal: This is the ultimate solution when the band has
penetrated inside the gastric lumen (erosion or migration), or if there is an
intractable food intolerance even when the band has been totally
deflated.
- Switch to another procedure: When a new band is deemed impossible or hasardous or
pointless, particularly if the previous one has been unefficient, then a new
procedure should be proposed: gastric bypass is most often suggested, but
sleeve gastrectomy can be an option (see chapters refering to these
methods).