If you are obese, weight loss surgery has the power to completely transform your life. Successful gastric bypass usually results in rapid weight loss that reverses many of the conditions brought on by obesity, including joint pain, high blood pressure, sleep apnea and type 2 diabetes.
For some patients, the initial weight loss can be followed by weight regain and in some patients the return of pre-existing medical conditions. In many cases, we find that weight regain is related to changes in the gastric pouch and pouch bowel connection (the stoma). Fortunately, a
revisional bariatric procedure known as the “band over bypass” can address the issues with your pouch and get you back on track.
What Is Band Over Bypass Surgery?
Band over bypass surgery is a procedure designed to correct the effects of a failed gastric bypass. Patients with failure of the gastric bypass may note the following: regaining weight after the initial weight loss, overall weight loss that is less than expected, a decrease in quality of life or a return of health conditions such as high blood pressure or diabetes that had resolved.
During a band over bypass procedure, an adjustable gastric band is placed around the pouch above the stoma to restrict the amount of food that can enter the stomach pouch. An injection port is also placed under the skin in the abdominal wall, as in a standard gastric band procedure. Using this port, the band can be easily inflated or deflated as needed. This band inflation and deflation is performed in the office.
Benefits of the Procedure
The goal in this instance is to get the patient back on track and create an environment that encourages continued weight loss. The benefits of a band over bypass include:
Improved Focus – With the new restrictive hardware limiting how much food can be taken in, patients often feel a renewed focus on losing weight after the band is placed.
Improved Weight Loss – When the gastric band is placed around the pouch, weight loss usually resumes. The weight loss resembles that of a patient receiving a gastric band as an initial bariatric procedure- typically about a pound a week for a total of 50-60 pounds in the year after surgery.
Easily Adjusted – The port in the abdominal wall allows for easy adjustment when the band needs to be inflated or deflated. This feature enables surgeons to fine tune the band so it is at the right tightness to achieve maximum results.
Safety – As a revisional procedure, placing a band over the initial bypass is a lot safer than attempting a surgical revision as there is no stapling or sewing of bowel. The gastric band has a stellar safety record as a standalone bariatric procedure.
The recovery for band over bypass surgery is basically the same as if you’d had gastric band surgery. Patients usually remain in the hospital overnight, and can return to normal activity levels in roughly one week.
The band over bypass procedure is safer than redoing the gastric bypass or stapling sections of your stomach, but it still carries some risks. Along with the normal risks associated with going under anesthesia, band over bypass risks include:
• Erosion of the band into the gastric pouch.
• Infection at the port site or from the band.
• Band slipping out of position, requiring another revision.
• Bleeding at the incision sites
• Blood clots
• Pneumonia and other lung problems
Post-Op Dietary Guidelines
Post-operative diet guidelines after band over bypass surgery are the same as if you were having a gastric band procedure without a previous gastric bypass. Patients will be instructed to follow pureed diet for 4 weeks after surgery then return to solid foods. The eating regimen emphasizes protein which works well with the small size of the pouch.
Follow Up Plan
The follow up for band over bypass surgery is similar to that of gastric band surgery. You will have an appointment shortly after the surgery to check your incisions, and then monthly appointments to evaluate your progress.
If the band needs adjusting to increase or decrease food intake, it will be decided during one of your follow up visits. For this reason, it is important to keep your appointments, or reschedule quickly if you are forced to miss one for any reason. The band must be kept in the right zone of tightness for it to help you so regular followup is critical for success.
If your gastric bypass surgery isn’t producing the results you’d hoped for, contact the Manhattan office of the New York Bariatric Group today for a consultation to talk about the band over bypass procedure.