Presentation and management of port disconnection after laparoscopic adjustable gastric banding.
OBJECTIVE
Laparoscopic adjustable gastric banding (LAGB) is a common and effective minimally invasive procedure in the treatment of morbid obesity. Port and connection tube complications are rarely reported. The aim of this study was to find presenting signs and predictors of tube disconnection from the access port that allow prompt diagnosis and appropriate treatment.


METHODS
A retrospective chart review was performed on the 29 patients who underwent 31 laparoscopic reconnections of the connecting tube following LAGB during a 10-year period.


RESULTS
Presenting signs were sudden lower-abdominal pain and free food passage following by weight gain and inability for band adjustment. Additional imaging was used to confirm diagnosis in the first three patients. Diagnostic laparoscopy for suspected acute appendicitis found tube disconnection from the port in one patient. Laparoscopic reconnection was successful in all patients. Access port exchange was done in 23 cases. Two patients had recurrent port disconnection. Band exchange was performed after second port reconnection.


CONCLUSIONS
Sudden onset of flank or abdominal pain, free eating, weight gain, and inability to adjust the band are signs of port disconnection after LAGB. Education and information for medical staff and patients can help in early recognition of this complication and avoid unnecessary investigations.
Kirshtein
Boris
B
Department of Surgery A, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 151, Beer Sheva, 84101, Israel. borkirsh@bgu.ac.il
Avinoach
Eliezer
E
Mizrahi
Solly
S
Lantsberg
Leonid
L
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004868:Equipment Failure; D005260:Female; D021501:Flank Pain / Q000209:etiology; D015391:Gastroplasty / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D015430:Weight Gain; D055815:Young Adult