Conversions and complications in 185 laparoscopic adjustable silicone gastric banding cases.
BACKGROUND
Kuzmak's gastric silicone banding technique is the least invasive operation for morbid obesity. The purpose of this study was to analyze the complications of this approach.


METHODS
Between September 1992 and March 1996, 185 patients underwent laparoscopic gastroplasty by the adjustable silicone band technique. A minimally invasive procedure using five trocars was performed.


RESULTS
In 11 patients exposure of the hiatus was impeded because of hypertrophy of the left liver lobe which led to conversion in eight patients and abortion of the procedure in three other patients. Anatomical complications: We observed two gastric perforations and one band slippage at the early stage, one infection and three rotations of the access port. Functional complications: There were eight (4%) cases of irreversible total food intolerance resulting in pouch dilation and eight cases (4%) of esophagitis. One fatality on the 45th day in a patient with a Prader-Willi syndrome.


CONCLUSIONS
The most disturbing complications of gastric banding technique are gastric perforation and pouch dilation. Their incidence may be reduced by improving the technique and by considering pitfalls of the procedure.
Chelala
E
E
Department of G.I. Surgery, University Hospital Center Saint-Pierre, rue Haute, 322 1000 Brussels, Belgium.
Cadiére
G B
GB
Favretti
F
F
Himpens
J
J
Vertruyen
M
M
Bruyns
J
J
Maroquin
L
L
Lise
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications; D012828:Silicones / Q000627:therapeutic use; D013270:Stomach / Q000601:surgery*
D012828:Silicones