had by-pass now want lap band

Question
hi,my name is andrea.on may of 2000 i had gastric bypass surgery. i lost 157lbs total. oves the years i but half the weight back on. i want to know if i can have a lap band???

Answer
Hi Andrea,

There are some surgeons who will put a gastric band over a gastric bypass, but usually before this can happen, there are some more fundamental questions that have to be addressed.

I think the real question is why have you regained weight?  It is pretty common for patients to regain about 10% of their weight, but if you have regained half, something else is going on.  One thing that can happen, and this sounds like your concern, is that the opening between your pouch and your small intestine (the stoma) can stretch, providing you with less restriction.  In order to determine this, your doctor need to order special radiology studies to look and see what is going on.  The best place to start this process is by going back to your surgeon.  If you really have this kind of stretching there are options for revisions (a band can be one, there is also a new procedure called a Stomaphyx) - and these things your surgeon can discuss with you.

Often, however, the problem is not surgical.  If everything is normal with your pouch, it may be that you have changed your diet and exercise patterns over the past 8 years such that you are regaining weight.  Whether or not a revision is the right choice for you, it is a good idea to revisit your support group and perhaps meet with your program dietitian to make sure you are still on track to be successful with your gastric bypass long-term.  You may find that your program has a "back-on-track" or advanced patient group designed for patients like yourself who are working on long-term issues. There are also some on-line groups that offer this kind of support - you can look both at Barbara Thompson's site (www.wlscenter.com/) and Colleen Cook's site (http://www.bariatricsupportcenter.com) as possible options.

Please let me know if you need more information.  I know that weight regain is scary, but it is almost always manageable.

In Health.

Dr. Jacques

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