1. A patient who had an adjustable gastric Lap-Band placed 36 months ago, feels over restricted. An.

1. A patient who had an adjustable gastric Lap-Band placed 36 months ago, feels over restricted. An UGI contrast study demonstrates a symmetrically dilated pouch. All the saline is removed from the Lap-Band and 6 weeks later, a repeat UGI study showed that the pouch is no longer dilated. After a few adjustments the patient feels overrestricted again, and a repeat UGI contrast study shows a symmetrically dilated pouch. During this period, she follows up a few times with the nutritionist and follows her advice. Which is the BEST management option? A. Remove the adjustable gastric Lap-Band. B. Remove the adjustable gastric Lap-Band, and do LRYGB during the same operation. C. Remove the adjustable gastric Lap-Band and place another Lap-Band. D. Advise her that she will need frequent readjustments of the adjustable gastric Lap-Band for the rest of her life.

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