title: Management of laparoscopic adjustable gastric band erosion.
abstract: Laparoscopic adjustable gastric banding (LAGB) was a popular procedure in the USA and Europe in the past decade. However, its use has currently declined. Band erosion (BE) is a rare complication after LAGB with a reported incidence rate of 1.46 %. Controversies exist regarding the management, approach and timing for the band removal. The aim of this study is to describe the rate, clinical presentation and perioperative outcomes of BEs at our institution and provide overall recommendations regarding the diagnosis and management of BE.
  
  
  
  This study is a single-center, retrospective review of a prospectively maintained database. Data were collected from all consecutive patients who underwent a LAGB and band revisional surgeries at the University of Illinois Hospital and Health Sciences System from December 2008 to September 2015. We identified patients who underwent gastric band removal due to a BE and analyzed their outcomes.
  
  
  
  A total of 576 LAGBs were performed at our institution. Nine patients underwent surgery for BE at our hospital. The average time between the primary surgery and the removal of the band was 68.5 (42.9) months. Abdominal pain, nausea and/or vomiting were the most frequently mentioned symptoms. In all patients, a minimally invasive approach was used to remove the band. The mean length of hospitalization was 2.6 (1.1) days. The only complication was a pneumonia (n = 1).
  
  
  
  BE is one of the most severe complications of LAGB. The minimally invasive approach provided us with the opportunity to repair the fistula, and it was associated with a prompt recovery with very little morbidity. In general, it is recommended that the band be removed at the time of the diagnosis of the BE. Endoscopic band removal can be utilized with patients who have a more advanced BE and migration into the gastric lumen.
authors.affiliation: Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 South Wood Street, Suite 435E, Mail Code 958, Chicago, IL, 60612, USA. pquadri@uic.edu.
authors.forename: Pablo
authors.identifier: 0000-0002-0894-6891
authors.initials: P
authors.lastname: Quadri
authors.affiliation: Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 South Wood Street, Suite 435E, Mail Code 958, Chicago, IL, 60612, USA.
authors.forename: Raquel
authors.initials: R
authors.lastname: Gonzalez-Heredia
authors.affiliation: Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 South Wood Street, Suite 435E, Mail Code 958, Chicago, IL, 60612, USA.
authors.forename: Mario
authors.initials: M
authors.lastname: Masrur
authors.affiliation: Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 South Wood Street, Suite 435E, Mail Code 958, Chicago, IL, 60612, USA.|Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Sanchez-Johnsen
authors.affiliation: Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 South Wood Street, Suite 435E, Mail Code 958, Chicago, IL, 60612, USA.|Division of General Surgery, Department of Surgery, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Enrique F
authors.initials: EF
authors.lastname: Elli
mesh_terms: D000328:Adult; D020878:Device Removal / Q000379:methods*; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States
keywords: Band erosion; Band erosion management; Gastric band complications; Gastric band revisional surgery; Laparoscopic adjustable gastric banding