Archives: September 2025

From Lap-Band® to Lasting Results: Removing or Converting Your Gastric Band

When the FDA approved the Lap-Band® in 2001, it was a revolutionary medical device. Patients had an adjustable and fully reversible bariatric surgical procedure for the first time.

Up to that point, procedures in Europe and Australia were considered equivalent to gastric bypass; the only surgical alternatives were more invasive, often open operations involving stomach stapling. With the new gastric band technology came incredible hype, marketing, and a boom in band placements. Over the next decade and a half, hundreds of thousands of patients had bands placed in their bodies with varying degrees of success.

Over time, while some patients lost a significant amount of weight, the band had some critical drawbacks. Unlike most other bariatric procedures, it offers no hormonal or malabsorptive benefits – weight loss relies solely on the band’s restriction. Hunger persisted, yet recipients could no longer eat as much as before.

More concerningly, the complication rates of the band over the long term became untenable. There was slippage of the band, where it moved out of place and caused significant symptoms or a lack of restriction; other patients experienced erosion of the band into the esophagus. Some patients even experienced flippage of the injection port used to adjust the band.

All of these complications required further surgery, and patients were not achieving the kind of excess body weight loss that stapled surgical procedures, such as a gastric bypass or gastric sleeve, offered.

How We Convert a Gastric Band

If you’re wondering why we don’t simply remove the band, it’s because once the restriction is gone, significant weight regain usually follows. While a band could theoretically be replaced, most patients opt for a conversion to a stapled procedure instead, avoiding the long-term risks of repeated band complications.

Because the band does not permanently alter the anatomy of the gastrointestinal tract, patients requiring a conversion have the option of any other bariatric surgery, including the gastric sleeve, gastric bypass, or, for patients with relatively higher BMIs, a duodenal switch or SADI.

What Is the Operation Like

Patients are under general anesthesia for the entire procedure, which starts with the removal of the band. The contents of the band are drained, the band cuff is cut, and then it’s removed from the abdomen. The conversion procedure is then performed almost as if it were the primary bariatric surgery.

The entire procedure takes approximately one to two hours, depending on the type of surgery being performed and the condition of the band. The downside is that potential risks and complications of the conversion procedure are higher due to the presence of scar tissue from the initial band placement.

That said, patients who tackle weight regain early enough (i.e., at a lower weight and in a healthier state) may actually have a lower surgical risk than they did during their initial procedure. If the band has eroded into the esophagus, however, your surgeon may delay the conversion procedure and perform it separately once the stomach and/or esophageal tissue has healed.

Choosing the Right Surgeon for a Conversion

Among the many decisions a patient faces, choosing the right surgeon for a revision procedure is critical. Conversion operations are complex, and selecting the most appropriate surgical method is equally important.

Choosing an experienced surgeon with an impeccable track record in all major bariatric procedures, including the sleeve, bypass, duodenal switch, and SADI, ensures that you receive proper guidance without inherent bias for one procedure or another. Furthermore, a highly skilled surgeon in conversion procedures may have a better understanding of the complexities and potential complications that may arise during surgery.

If your gastric band/lap band is functioning well and you’re not experiencing complications, a revision may not be necessary. Revisions are typically reserved for patients facing significant weight regain or band-related issues.

At SAMPA, we welcome your questions and can help you determine if a conversion surgery is right for you. Contact our team today to schedule a consultation and explore your options with an experienced conversion bariatric surgeon.

Pre- And Probiotic Sodas, And How They Impact Colon Health

You’ve likely seen significant advertising for a new type of soda that claims to be healthy for your gut, possibly even aiding weight loss. But are the sodas all they claim to be? Should we consider the potential downsides? Could any of them actually be detrimental to our health?

A Colorectal Surgeon’s View

As colorectal surgeons, we are always aware of anything that may positively or negatively affect the gut microbiome. Often, we see patients with multiple health issues that ultimately stem from bacterial imbalances in the colon. As we have come to better understand the gut microbiome over the years, it has become increasingly evident that it affects virtually every part of the body.

While surgeons have well-defined procedures for treating colorectal diseases, both benign and malignant, we don’t yet have a complete understanding of how our environment and diet affect the microbiome at the cellular level. To that end, numerous misconceptions surround the rebalancing of gut flora for improved health.

One of the newest trends in the beverage industry is the emergence of “healthy” pre- and probiotic sodas. It’s no surprise that sodas are among the most widely consumed beverages in the United States and worldwide. Most of us overlook the empty calories and high sugar levels because they taste so good and are refreshing after a long day. However, the high sugar content, and especially the enormous amount of fructose consumed very quickly when drinking a soda, can cause several issues, including liver, urinary, metabolic, and colorectal concerns.

The new wave of sodas has laid claim to the “healthy” mantle, and to some degree, there is validity to this. Compared with traditional, sweetened sodas, these probiotic sodas may offer some benefits. However, when taken on their own and compared to water or low-calorie, low-sugar drinks with no artificial sweeteners, the picture changes significantly. These sodas, although lower in calories, often still contain artificial sweeteners to achieve a palatable taste.

“I’m aware that for some of my patients, soda has been a way of life and it’s not easy to eliminated in favor of water or low-calorie beverages like coconut water.” says Dr. Greg Quatrino, “but I do have to caution my patients that while advertising makes new sodas, seem healthy, they are not and can still cause significant disruption to the microbiome.”

The Bottom Line

While these beverages may offer a marginally better alternative to full-sugar sodas, they should not be viewed as a health supplement. They are processed beverages that often contain sweeteners, which can disrupt gut health on their own. If you enjoy the taste, consume them in moderation, but do not rely on them to fix a poor diet. The best way to support your microbiome remains a diet rich in whole foods, natural fiber, and plenty of water.

How Do I Know I’m On the Proper Diet After Bariatric Surgery?

We all want to be successful in our weight loss endeavors, and bariatric surgery is an excellent tool to help make that happen. However, bariatric surgery is just that – a tool.

Unfortunately, it is not a silver bullet to help you lose all the weight you need without working hard. To that end, changing your diet and improving your exercise habits are critical to ensuring that you lose weight safely and rapidly, and maintain that weight loss over the long term.

When a patient is more than six months post-surgery, they tend to start taking greater responsibility for their diet and exercise routine. In other words, the convenient postoperative packet we provide is less prescriptive than it was during the first six months. As a result, many patients worry that they may be veering off track with their diet.

So, let’s find out how to determine if you’re on the proper diet.

The diet shouldn’t feel like a diet

This sounds like a strange concept for someone who may have been used to overeating or constantly dieting; however, the long-term postoperative bariatric diet is not meant to be a diet. A diet, after all, is in and of itself a temporary phenomenon. Instead, this is a lifestyle change. This is a new direction in eating habits that involves consuming an appropriate number of calories for your weight and lifestyle.

There’s no exact number that applies to every patient, and there is no “best diet” out there. If you are more active, you’ll require more calories. Similarly, as you lose weight, you will need fewer. The key here is to remind yourself that this is the new reality and to work hard to find foods that taste good but also fit within the bounds of your dietary restrictions after surgery. Evidence shows that the most effective diet is the one that you can keep doing over a long period of time.

One of the greatest advantages of bariatric surgery is that there are very few absolute restrictions on the foods you can enjoy. That said, we strongly recommend limiting added sugars, highly refined carbohydrates, and ultra-processed foods. Diets consistently lower in sodium, added sugars, and ultra-processed ingredients have proven very effective for our patients. Research also supports that minimizing these components not only improves overall health but also enhances the success of any weight loss program, making results more sustainable over the long term.

You can indulge in small treats here and there, albeit not the way you used to. If your favorite dessert is being served on a holiday, take a small slice and enjoy it. Remember that this should not be a daily treat, but a once-in-a-long-while indulgence. On the flip side, if doing it here and there causes you to crave more and more sweets, it may be better if you choose not to eat them at all or find healthier replacement options.

Dieting should be easy and repeatable

One of the problems with dieting, over time, is the human tendency to go to extremes. If you are transitioning into a new diet, whether it’s keto, Mediterranean, or otherwise, it serves you best to ease into it slowly, so it doesn’t feel like a huge life change.

The problem with going to extremes is that one slip-up can quickly set you back to where you started: frustrated, upset, and tempted to give up on what could otherwise have been a successful diet. Because of this, it’s also essential to consult a professional before beginning any new eating plan. Your nutritionist, dietitian, bariatric nurse, or surgeon can guide you toward diets that have worked well for their patients and, based on your personal preferences, may be best suited for your circumstances.

It’s important to remember that there is no one-size-fits-all diet. What works for one person may be completely counterproductive for another. The key is to experiment, stay patient, and make informed choices that support long-term success.

For many patients, weighing foods is a helpful strategy to ensure portion sizes are correct. Soon enough, your body will be so accustomed to the new portion sizes that you won’t need to use the scale to determine how much you should be eating.

Eating out, though, may still require some diligence, as you really don’t have any control over how the kitchen prepares the food, even if you do mention your dietary requirements. A little caveat worth mentioning is ordering from the kids’ menu. While that can seem like a great option proportionately, it still may not be the healthiest. It’s better to ask for a to-go box or ask your server to split the entire entree before they even bring it to your table.

Your diet should be relatively easy to follow, but what exactly does that mean? Just like your exercise program, the best diet is the one that you can stick to. If you hate every moment of being on that diet, it is most definitely not the right one for you. Similarly, if you dislike your workout routine, you’re likely to become frustrated and lose motivation, eventually quitting and forfeiting all the fantastic gains you’ve made. Once again, there is no perfect diet for every patient – know that it’s hard work, but that you can also make it enjoyable.

Make no bones about it – diet and calorie restriction will not be easy at the beginning. You might experience headaches, cravings, and more. This is all very normal, and you do have to push through with willpower to get past it. However, over the long term, your diet should start becoming second nature to you – it should not feel like you are making an unreasonable sacrifice to keep the weight off. If you continue to struggle or just need assistance, you can always talk to your provider about meal options and/or obtain a referral to a registered dietician.

Bonus tip: The amount of weight you lose each week can help you determine whether your diet is adequate.

Over the first six months after bariatric surgery, you will be losing a significant amount of weight, and you will feel like the pounds are just melting off. You may even be alarmed at how much weight you lose and wonder if it will ever slow down. How much you lose at first depends on what type of bariatric surgery you had. For example, a patient who had a duodenal switch will lose a lot more weight than somebody who had a gastric sleeve.

Eventually, you will reach plateaus. Some of those plateaus you will bust through and continue to lose weight in the future.

From about six months onwards, aim for one to two pounds of weight loss per week, resulting in a total of four to eight pounds of weight loss per month. If that doesn’t feel like a lot, bear in mind that by the end of the year, if you have followed this strategy, you’ll have lost between 50 and 100 pounds. No small feat! (Again, based on the type of surgery and surgeon recommendations, this could look different for everyone.)

How you lose the weight matters

If you’re finding that you’re gaining weight rapidly and then losing it once again very rapidly by starving yourself, you know that you’re not on the proper diet. Similarly, if you have reached your goal weight and are yo-yoing, you may be doing the wrong thing. Stress eating and stress starving are signs that it’s time to see your surgeon and advanced practitioner. They can provide many resources for you with possible pharmacological interventions.

Should you supplement with GLP-1s?

GLP-1 medications can be an effective tool for patients to maintain weight loss after reaching their goals or to get back on track if they start regaining weight following bariatric surgery. However, they should not be considered a long-term alternative to diet and exercise for maintaining or losing weight.

Unfortunately, these drugs can get very expensive, and we also know that they only work for as long as they are taken. To that end, speak with your SAMPA bariatric surgeon to better understand your postoperative needs and whether a GLP-1 medication can help you achieve and maintain your goals in the long run.

Just be mindful that a combination of a proper diet and vigorous exercise will not only make you feel better physically and mentally, but also help you maintain the weight you want.

The bottom line

Remember that when it comes to weight loss, everything should be in moderation. This is a journey, and oftentimes people will have ups and downs during the process. If you’re experiencing extreme weight fluctuations or must make significant lifestyle changes to maintain your weight, it’s important to address any potential longer-term issues or concerns by consulting a qualified professional, such as those at SAMPA or your current weight loss care provider.

A Local Surgeon and Global Technology: Dr. Ballard and the da Vinci Advantage

For many patients, surgery comes with two big questions: Who will be performing it? And what tools will they be using? At Surgical Association of Mobile, you don’t have to choose between expertise and innovation. With Dr. Barry Ballard and the da Vinci Surgical System, patients get both: the steady hand of a trusted local surgeon and the precision of world-class technology.

Just how innovative is this? The procedures Dr. Ballard has performed using the da Vinci technology were the very first to be done in an outpatient surgical center in Alabama – a groundbreaking moment that brings cutting-edge care closer to home.

Meet Dr. Barry Ballard

Born and raised in Mobile, Dr. Ballard knew from the time he was in high school that surgery was his calling. He got his start scrubbing in as an orderly at Springhill Memorial Hospital, and after completing his medical degree at the University of South Alabama and his general surgery residency at the University of South Alabama Medical Center, he chose to stay home to serve the community that shaped him.

Dr. Ballard is a Fellow of the American College of Surgeons and an active member of leading surgical associations. His specialties include:

• Bariatric surgery, including gastric bypass and sleeve gastrectomy
• Hernia repair
• Colon and rectal surgery
• Gallbladder removal
• Thyroid and parathyroid surgery
• Treatment for GERD and chronic acid reflux

Most importantly, Dr. Ballard is known for his patient-first approach. He listens, explains, and makes sure every individual understands their options before moving forward.

What Is the da Vinci Surgical System?

It’s easy to assume the word “robot” means the machine is operating on its own. In reality, da Vinci is a surgeon-controlled system, acting as a highly advanced tool that extends a surgeon’s vision and movement beyond what’s possible with the human hand alone.

From the surgeon’s console, Dr. Ballard controls tiny wristed instruments that can bend and rotate far more precisely than the human wrist. The system translates his movements into real-time surgical action – steady, scaled, and precise.

What Does This Mean For Patients?

• Smaller incisions and less scarring
• Less blood loss and reduced risk of complications
• Less pain after surgery
• Faster recovery and return to daily life

The da Vinci technology enables Dr. Ballard to perform complex procedures through minimally invasive approaches that were once only possible with open surgery.

Features in Everyday Language

The da Vinci offers features that sound high-tech on paper, but this is how it breaks down:

• Sharper vision for the surgeon: Dr. Ballard sees the abdominal anatomy in magnified 3D detail, down to tiny vessels and tissues.
• Real-time guidance: Firefly technology illuminates blood flow and bile ducts, enabling Dr. Ballard to protect delicate structures.
• Greater flexibility: The system’s wristed instruments move with more agility than the human hand, allowing Dr. Ballard to navigate tight spaces with ease.

What makes the da Vinci system remarkable isn’t the technology alone, but what happens when it’s placed in the hands of a surgeon like Dr. Ballard: someone who combines hometown dedication with world-class training and precision.

With Dr. Ballard and the da Vinci, patients can trust they’re receiving advanced care that’s both cutting-edge and compassionate.

da Vinci FAQ

Is robotic surgery safe?
Yes. Robotic surgery is not an “autopilot” system – da Vinci is completely controlled by Dr. Ballard. The technology simply enhances his vision and precision. Like any surgery, there are risks, but robotic surgery is considered very safe and has been performed in millions of procedures worldwide.

Will a robot perform my surgery?
No. Dr. Ballard performs every aspect of your procedure. The da Vinci system is a set of advanced tools that extend his capabilities, allowing him to work through smaller incisions with greater accuracy.

What types of procedures can Dr. Ballard perform with da Vinci?
Dr. Ballard uses the da Vinci for a variety of bariatric and general surgeries, including gastric bypass, sleeve gastrectomy, hernia repair, gallbladder removal, and more.

How do I know if I’m a candidate for robotic surgery?
Not every procedure or patient is suited for robotic surgery. Dr. Ballard will meet with you, review your medical history, and determine whether robotic surgery is the safest and most effective option for your situation.

What should I expect during recovery?
While recovery varies by procedure and individual, most patients experience less pain, shorter hospital stays, and faster healing compared to open surgery. Dr. Ballard and his team will give you a personalized recovery plan.