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Dr. Mehran: The options that somebody may have when undergoing revisional surgery are
to keep the band; that has its pros and cons. Invariably the vast majority of these bands
will require reoperation. The question is, when will that happen? And when that happens,
the duration of which it has been sitting in the abdomen could lead to more serious
scarring and problems that you will run into when you try to do revisional surgery.
When patients consider revisional surgery, it's either because of complications such
as slippage, erosion, tubing problems, port problems and numerous other issues, or it's
because it just doesn't work or it has stopped working or they are just sick and tired of
getting adjusted and needled and going back and forth.
When you want to revise these surgeries, you can either do them at the same setting, there
are pros and cons to that. In some patients it's okay to do it, some, it's not. The other
way to do it is to do it on two steps. To take the band out and then wait till everything
cools off and then come back and do the other operation later, once they've been adequately
and properly prepared to have the more major surgeries done.
So it's a discussion that really depends on the patient himself. You really can't blanket
it for everybody, you have to do it custom-made.