Bariatric surgeons at Upstate are performing a growing number of operations to fix problems created when gastric bands slip inside patients who previously underwent weight loss surgery.

Up to 25 percent of the people with adjustable gastric bands experience trouble, ranging from slippage of the band to erosion through the stomach wall, says Dr. Howard Simon, MD, chief of bariatric surgery at Upstate. Bands have been used in recent years to reduce the size of the stomachs of people who are drastically overweight, and they are FDA-approved for obesity treatment. The procedure helps people lose weight, but overeating, drinking carbonated beverages or excessive vomiting can cause the band to shift. This leads to additional operations and, sometimes, removal of the band and weight re-gain.

Simon says Upstate surgeons no longer offer bands as an option. “We believe a ‘sleeve‘ is better in every possible way,” he says, referring to a surgical option in which part of the stomach is removed. About 30 percent of the weight loss surgery patients at Upstate have gastric sleeves. About 70 percent have gastric bypasses, a procedure in which a pouch is fashioned from the stomach and then connected to the small intestine.

Because Upstate University Hospital and Simon have offered bariatric surgery since the 1970s--longer than any other hospital or surgeon in Syracuse--many patients who had their gastric bands implanted elsewhere seek the expertise of Upstate when they require additional surgery.

The two most common problems are inadequate weight loss and band slippage, Simon says. If a person has had a gastric band in place for two or three years without reaching their weight loss goal, he or she may need surgery for a gastric bypass or a sleeve – procedures that permanently reduce the size of the stomach.

If a person has a band that slips and obstructs the stomach, the band will have to be removed, he says. In those instances, weight re-gain is a serious concern. “I've seen patients who have had bands come out regain 100 pounds in three months.”

How would someone know his or her gastric band has slipped? Some symptoms include nausea, acid reflux, difficulty eating or the ability to eat more than usual. Simon says follow-up appointments with the surgeon who originally placed the band are important, too.

Upstate surgeons (Simon, plus Drs. Taewan Kim, MD and Matthew McDonald, DO) perform about 500 bariatric surgeries per year, including a couple of band revisions every month.

To be a candidate for weight loss surgery, a person must be obese or overweight with medical complications such as diabetes, sleep apnea or high blood pressure. At Upstate, people must demonstrate the ability to improve their eating habits.  “People need to understand that the operation done, without changing your habits, has no chance of being successful. None,” Simon says.

He adds that 80 percent of those who undergo weight loss surgery are successful in keeping the weight off.

Listen to interview with Dr. Simon about gastric band slippage

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