Band and port-related morbidity after bariatric surgery: an underestimated problem.
OBJECTIVE
To evaluate the magnitude of the morbidity related to the system used for gastric banding Methods Between January 1997 and December 2004, 286 consecutive patients underwent laparoscopic gastric banding (LAGB) in one center. We used 4 models of LapBand 9.75, 10, 11 and Vanguard with pars flacida route. Recalibration of band was performed in our consultation unit without systematic radiologic control. We considered four kinds of complication: port displacement, port rupture, band rupture and others problems.


RESULTS
The mean follow up was 3.3+/-2.8 years with a median 2.9 years. Complications occurred within a mean time of 2.2+/-1.9 years. For the models vanguard and size 11, there were no rupture and 15 (27.7%) displacements whereas for size 9.75 and 10 there were 39 ruptures (14.7%) and 15 (5.6%) displacements. Types of complications were related to the bands used i.e. more port displacements for the models vanguard and size 11 and more band and port ruptures for the models size 9.75 and 10. But when we considered the respective follow up according to the type of band these differences were no longer significant. Moreover rupture rate was significantly high but decreased after March 2002 because of changing of junction between port and catheter. Mean excess weight loss (35.2+/-27.7%) was not different in group whether the patients were reoperated or not.


CONCLUSIONS
Band and port related morbidity is an important aspect of bariatric surgery. We have to pay attention to material evolution and to our follow up for calibration. Some new recent technical advancement could improve the management of these patients.
Launay-Savary
M V
MV
Department of Digestive Surgery, CHU Clermont-Ferrand, Hôtel-Dieu, CHU Clermont-Ferrand Boulevard Léon Malfreyt, 63058, Clermont-Ferrand, France. mvsavary@chu-clermontferrand.fr
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D015992:Body Mass Index; D004867:Equipment Design; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D009017:Morbidity; D012086:Reoperation