I feel for the patient asking this question because they've already undergone a major surgery in having an abdominal reconstruction or a large hernia repair with mesh and over time they've seen significant weight gain that has led them to consider bariatric surgery. Now in terms of doing bariatric surgery or replacing a lap band after a mesh has been inserted in the abdominal wall, it can be done. The only consideration has to be whether intestinal adhesions will develop under the abdominal wall up against that mesh. If that's the case those intestinal adhesions will have to be surgically cut down off the mesh and lowered so that you can then see the stomach, introduce the band and wrap it around the stomach. It just adds risk, it takes a fair amount of time and a gentle hand to separate the adhesions between the intestines and the mesh and avoid cutting those intestines and accidentally spilling bacteria into the abdominal cavity. If you spill bacteria into the abdominal cavity, you can't really put the band in because of the risk of infection and seeding that band with bacteria. So, there's a chance if you do have surgery to have a Lap-Band in placed and there are significant amount of intestinal adhesions to a previously placed mesh, that at some point should those intestines accidentally be injured and there's spillage, that the case will have to be aborted and an attempt at placing a Lap-Band will have to be revisited at a later date.
