Results of lap rebanding procedures after Lap-Band removal for band erosion -- a mid-term evaluation.
BACKGROUND
Late band erosion is an uncommon complication after laparoscopic adjustable gastric banding (LAGB). Overall erosion rate in our practice is approximately 1.6%. Our first 10 erosion patients underwent a rebanding procedure after previous Lap-Band removal. This study gives the results of midterm follow-up.


METHODS
10 patients underwent Lap-Band removal for erosion. Then, 4 to 6 months after band removal, between December 1999 and February 2002, the 10 patients underwent LAGB again. Post-operatively, patients were seen at least every 3 months, and routine endoscopy was performed 1, 2 and 3 years after rebanding. Follow-up in this study was 36-63 (mean 48) months.


RESULTS
No postoperative complications occurred; however, the first patient required conversion to laparotomy. Mean BMI was 40.6 (34-50) at the time of the initial LAGB, 34.3 (31-44) at the time of rebanding, and is 28.5 (22-38) at present. There have been 2 late complications: 1 pouch dilatation and 1 port leak. No re-erosions have developed. Satisfaction has been excellent in 9 patients and moderate in 1.


CONCLUSIONS
Laparoscopic rebanding is a safe, feasible, minimally invasive and efficacious option as a second bariatric procedure after Lap-Band removal for erosion. However, if the patient is not pleased with the first band, a different bariatric operation should be considered. Our results in the mid-term are excellent, but longer follow-up is necessary to draw definitive conclusions.
Niville
Erik
E
Department of Abdominal Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium. erik.niville@pandora.be
Dams
Anne
A
Van Der Speeten
Kurt
K
Verhelst
Hans
H
D020878:Device Removal; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000295:instrumentation*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012086:Reoperation