REALIZE™ Band Revision Surgery

After REALIZE™ Band surgery, patients may need revision weight loss surgery for a number of reasons. The REALIZE band could slip leading to a slow chronic condition or an acute condition requiring emergency surgery. Both circumstances ultimately lead to the REALIZE band not functioning the way it should. While each circumstance is different, treating these issues may require removing the REALIZE band, repositioning the REALIZE band or replacing the REALIZE band all together. Removing the REALIZE band obviously opens the door for potential weight regain.

REALIZE band erosion is another possible complication of REALIZE band surgery. REALIZE band erosion occurs when the REALIZE band causes a hole to be worn into the stomach, making the REALIZE band rather ineffective. Patients may experience a single occurrence of vomiting blood as the first signal of REALIZE band erosion. The most frequent symptom of REALIZE band erosion is an infection around the site of the port. Due to erosion caused by the REALIZE band, saliva leaks through the hole in the stomach and flows along the REALIZE band tubing, causing the tissue under the skin of the REALIZE band port to become infected. Treatment requires removing the REALIZE band, leaving the patient with no weight loss surgery and a high likelihood of weight regain. It is often recommended to treat REALIZE band erosions by converting the patient to either laparoscopic gastric bypass or vertical sleeve gastrectomy. Since the portion of stomach that has been eroded is weakened and more prone to leaking, these weight loss surgery procedures should be done only after a waiting period of 2-3 months to allow for healing to occur.

The REALIZE band may simply fail to produce the desired results and require revision bariatric surgery. REALIZE band is a restrictive weight loss surgery and some patients may not have the metabolism needed to lose weight with the REALIZE band. Other patients may not be able to eat the way that is needed to achieve success after REALIZE band surgery. This may in turn lead to maladaptive eating behaviors ultimately resulting in failure and/or weight regain. REALIZE band failures may be converted to any other weight loss surgery but it should be considered that a patient will more likely achieve success if a more metabolically active procedure is performed instead of a purely restrictive weight loss surgery. There is a decent amount of evidence suggesting that a well managed REALIZE band is almost as good as gastric bypass over time, since both depend on maintaining restrictive eating via a similar size pouches. Converting a patient to gastric bypass after REALIZE band failure will produce best results since it will add malabsorption to restriction and control hunger.

For patients who want nothing but restrictive weight loss surgery, vertical sleeve gastrectomy is a great option. Vertical sleeve gastrectomy will still be limited by the metabolic activity of the surgery itself, in addition to the patients metabolism, but there are several reasons why the vertical sleeve gastrectomy will produce better results than the REALIZE band over time.