11-cm Lap-Band System placement after history of intragastric migration.
BACKGROUND
Intragastric migration (erosion) of the band after laparoscopic adjustable silicone gastric banding (LAGB) is a serious late complication. It requires removal of the entire system. Subsequent recurrence of obesity can be treated by laparoscopic placement of a larger band: the 11-cm Lap-Band System.


METHODS
In 727 laparoscopic gastric bandings using the 9.75 Lap-Band, 10 cases presented with intragastric migration of the band. The same complication was encountered in an additional 4 patients who had previously been implanted with an Obtech band in another hospital. Laparoscopic removal of the band was performed in all cases. In 9 cases, after a delay of 6 months, a new gastric band was placed using the 11-cm Lap-Band, because of uncontrollable recurrence of obesity.


RESULTS
No complication was observed during the laparoscopic removal of the system. The placement of a new band required conversion to laparotomy in 1 patient who had previously received an Obtech band which had been placed using the pars flaccida technique. After a mean follow-up of 21 months, no intragastric migration of the new bands was noted.


CONCLUSIONS
Laparoscopic placement of an 11-cm Lap-Band in patients with a history of intragastric migration is a safe procedure. It allows effective control of recurrent obesity. The laparoscopic procedure was easier in patients initially operated using the perigastric technique.
Vertruyen
M
M
Department of Laparoscopic GI Tract Surgery, Europe St-Michel Clinic, Brussels, Belgium. marcvertruyen@belgacom.net
Paul
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D001530:Belgium; D015992:Body Mass Index; D015331:Cohort Studies; D020878:Device Removal; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000517:prevention & control* / Q000601:surgery; D015391:Gastroplasty / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment