Treatment of intra-gastric band migration following laparoscopic banding: safety and feasibility of simultaneous laparoscopic band removal and replacement.
BACKGROUND
Intra-gastric band migration (band erosion) following laparoscopic adjustable gastric banding (LAGB) is a known complication requiring revisional surgery. Management has most often involved band removal and suturing of the stomach wall, followed by delayed replacement at a third operation. We report our experience with simultaneous band removal and replacement.


METHODS
Between May 2001 and December 2003, we performed 754 laparoscopic operations using the Lap-Band (R). Patients developing band erosion were treated by laparoscopic band removal and immediate replacement of a new band following gastric wall repair.


RESULTS
16 patients (2.1%) developed band erosion after a mean of 23 months following surgery (range 11-40 months). Patients presented with epigastric pain (6), port-site bulge (3) or were asymptomatic (7), band erosion being suspected during fluoroscopy for band adjustment and confirmed by gastroscopy. Postoperatively, 11 patients developed fever that responded to antibiotics. No patient suffered from intra-abdominal infection, wound infection, pneumonia or pulmonary embolism. Mean hospital stay was 4 days (range 1-8 days).


CONCLUSIONS
Band erosion following LAGB can be treated safely with simultaneous laparoscopic band removal, gastric wall suturing and immediate replacement of the band, thereby preventing weight gain, the appearance of co-morbidities and the need for additional surgery.
Department of Surgery B and the Advanced Endoscopic Surgery Service, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Israel. dr_subhi@tasmc.health.gov.il
Subhi
S
Abu-Abeid
Dan
D
Bar Zohar
Boaz
B
Sagie
Joseph
J
Klausner
D020878:Device Removal; D005260:Female; D005548:Foreign-Body Migration / Q000601:surgery*; D015391:Gastroplasty; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008297:Male; D011028:Pneumoperitoneum, Artificial; D012086:Reoperation