incisional hernia /unable to eat

Question
I had a vertical banded gastroplasty in 1998. Since then I have lost 100 lbs but gained it all back. However, I'm not sure why, since I've had nothing but problems eating and keeping things down. I also have constant diarrhea. Recently, (in the past 3 months), I have developed a very obvious hernia, which my PCP says is an incisional hernia. When I touch it, I can feel the band move, and it also makes noise. Some days I can eat something soft, like yogurt, other days I can't even eat that. I am able to drink clear fluids. It is getting so I am weak and unable to work for lack of energy, even though I'm trying to drink Boost, etc. I am an RN and I know I need vitamins, etc. My question is: do I see a bariatric surgeon, a plastic surgeon or a general surgeon. I would like to have this whole thing taken down, but especially want the band taken out, I won't go in for surgery unless this is promised. I do know that I make adhesions like crazy, and I believe that adhesions are around my band and possibly keeping food from passing through my band. I am at a loss... I want my normal life back but I'm scared and I don't know which way to turn.   Thank you.

Answer
Deborah,
Unfortunately this is a fairly characteristic situation with the (outmoded) Vertical Banded Gastroplasty.  This will be addressed the most effectively by an experienced bariatric surgeon.  You can find a surgeon in your area by searching the Center of Excellence website:

http://www.surgicalreview.org/locate.aspx

Best of luck!
Dr JP

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