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Band Over Bypass

As a revision procedure, band over bypass surgery has the purpose of restoring the size of the stomach to the size it had after the initial gastric bypass. Therefore, the only patients who are eligible for it are those who have previously undergone gastric bypass surgery and failed to maintain their weight afterward. While gastric bypass is one of the most effective and reliable bariatric surgeries available at the moment, relapse is not uncommon after the procedure or several years following it. If a patient fails to lose at least 50% of their excess weight after a bariatric surgical treatment, the procedure is considered unsuccessful, and therefore, a second surgery is necessary.

Entailing the placement of a lap band over the stomach, band over bypass will reduce the volume of the organ once again and prevent the patient from ingesting large amounts of food. It is the revision bariatric procedure with the lowest risk of postoperative complications. The silicone band which is to be positioned around your stomach is adjustable and inflatable. To qualify for the procedure, which is also known as gastric bypass band and gastric banding surgery, your BMI (body mass index) must be of at least 40 or of over 30 accompanied by health problems stemming from obesity, such as high blood pressure or diabetes.

As before any bariatric surgery, you will need to go through a series of tests meant to evaluate your current health, after which your surgeon will decide whether the band over bypass procedure is suitable for you.

They will include some of the following:

• blood tests such as creatinine, a complete blood count, electrolytes, prolactin, cortisol etc.
• electrocardiogram (EKG)
• pulmonary function tests
• a chest X-ray
• liver function tests
• urinalysis
• pH monitoring studies
• upper endoscopy
• eating test

Supposing you are eligible for band over bypass surgery, the date of the procedure will be set and your bariatric surgeon will instruct you with regard to what you should and should not do priorly.

In general, patients have to follow a preoperative diet for one or two weeks before the surgery.

They also need to quit smoking and refrain from drinking caffeinated beverages and alcohol. It is essential to comply with the instructions of your doctor, as your surgery might be canceled otherwise. On the day of the surgery, you must not have eaten for at least 12 hours, as your stomach has to be empty for band over bypass.

You will be put under general anesthesia for the procedure. Throughout the entire duration of the surgery, a bariatric nurse will monitor your vital signs and ensure everything is going smoothly. Since band over bypass is performed laparoscopically, the surgeon will make 1 to 5 small incisions in your abdomen through which the medical instruments will be inserted to carry out the procedure. The adjustable band will be positioned around your stomach and subsequently fixed with sutures. It will restore the size your stomach came to have following your gastric bypass.

Similarly to the original lap band surgery, a port connected to the band will also be positioned under the skin on your abdomen, which will allow the surgeon to control the tightness of the band. Finally, your incisions will be securely closed with stitches and a sterile dressing will cover each of them to prevent wound infection.

The benefits of band over bypass surgery are numerous, the most important being a short recovery time and a low risk of postoperative complications. Additionally, the procedure entails the following advantages:

• the surgery is reversible, as the band can be removed by a bariatric surgeon at any time
• while weight loss takes place at a slower pace than in the case of gastric bypass, band over bypass is a more healthy surgical treatment, since it will not lead to malabsorption of vitamins and nutrients
• decreases appetite and leads to satiety after eating small amounts of food
• since the anatomy of your digestive tract will not be further altered, the procedure implies a low risk of complications
• improves or cures health problems caused by excess weight, such as diabetes, heart disease, obstructive sleep apnea, or depression
• prolongs life quality and expectancy
• helps patients maintain a weight loss of approximately 55% in the long run
• does not require additional surgery, as the lap band can be adjusted via the port in your abdomen

In general, people lose 1 to 2 pounds per week after band over bypass surgery, supposing they adhere to the diet and exercise plan recommended by their bariatric surgeon and attend their follow-up appointments. Weight loss occurs over the course of up to 3 years following the procedure.

Since the procedure is carried out with the aid of a laparoscope, hospitalization time is very short – usually, one to three days. The majority of patients can return to their normal activities in 5 days, whereas complete recovery is achieved in approximately 3 weeks. A side effect of band over bypass surgery is hair loss, which will improve shortly after the patient begins consuming solid, nutritious food. Following a strict diet is essential after the procedure, as this will ensure weight loss. During the first 2 weeks, patients must only drink high-protein liquids. Subsequently, soft food is introduced into their diet and, when 4 weeks will have elapsed since the surgery, their diet will consist of solid foods low in carbohydrates until their goal weight is reached.

Band over bypass is a bariatric procedure with a very low mortality rate, as only 1 in 2000 patients dies afterward. It is worthy of note that the cause of death rarely has to do with the surgery itself, the culprit usually is a disease or condition stemming from obesity, such as a heart attack. People who suffer from lupus are typically not good candidates for band over bypass and neither are non-adults and individuals unwilling to commit themselves to a strict diet plan after the surgery.

Although seldom serious, the risks and complications of band over bypass surgery are:

• infection or bleeding inside the abdomen
• food trapping
• the band eroding into the lining of the stomach
• pouch dilation
• gastroesophageal reflux disease (GERD)
• band slip
• infection of the band or port
• changes in bowel function