Experiences of two centers of bariatric surgery in the treatment of intragastrale band migration after gastric banding—the importance of the German multicenter observational study for quality assurance in obesity surgery 2005 and 2006

Hohmann, U.; Will, U.; Flade-Kuthe, R.; Herbig, B.; Höhne, Stefan; Köhler, Hinrich; Pick, P; Horbach, T.; Weiner, Rudolf A.; Wolff, S.; Lippert, H.; Wolf, Anna Maria; Schmidt, Uwe; Meyer, Frank; Manger, Th.

doi:10.1007/s00384-008-0495-z

Cited by 20 publications

(26 citation statements)

References 36 publications

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“…12 and 13). Also, port site infection has been reported to be the first symptom of erosion, 22 as seen in some of our patients (Table 1). Although 1 study (23 pregnancies in a series of 359 patients) reported that pregnancy after adjustable gastric banding was not associated with severe complications, 23 band migration after pregnancy has occurred in other studies, 24,25 and severe vomiting in early pregnancy has been hypothesized to be the cause of band migration.…”

Section: Discussionsupporting

confidence: 58%

Endoscopic management of gastric band erosions: a 7-year series of 14 patients

Doğan

Akın

Yalakı

et al. 2014

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Background: Intragastric band migration is an unusual but major complication of gastric banding. We review our experience with endoscopic removal of eroded gastric bands. Methods:We retrospectively evaluated the cases of 110 morbidly obese patients who underwent adjustable gastric banding between 2005 and 2012 to identify those who experienced band erosion. To remove the migrated band, we used an endoscopic approach with a Gastric Band Cutter.Results: Band or tube erosion occurred in 14 patients (12.7%). The median time interval from the initial gastric band placement to the diagnosis of band erosion was 32 (range 18-52) months. Upper abdominal pain, port site infection, loss of restriction and weight regain were the most common symptoms. We used the Gastric Band Cutter to remove the band endoscopically. It was able to cut the band successfully in all but 1 patient, in whom twisting of the cutting wire required conversion from endoscopy to laparotomy. In 2 patients, the band, after being cut, was locked in the gastric wall and required laparotomic removal. In 1 patient, we performed surgery for intragastric pene tration of the connecting tube broken close to the band. Conclusion:The Gastric Band Cutter was successful in dividing the band in all but 1 patient, although we could not always complete the procedure endoscopically. Endoscopic removal seems to be effective and safe for band erosion.Contexte : La migration intragastrique de l'anneau est une complication rare, mais majeure du cerclage gastrique. Nous faisons le point sur notre expérience du retrait endoscopique des anneaux gastriques érodés.Méthodes : Nous avons évalué de manière rétrospective le cas de 110 patients atteints d'obésité morbide qui ont subi un cerclage gastrique ajustable entre 2005 et 2012 afin de vérifier si les anneaux en place étaient érodés. Pour retirer les anneaux qui avaient migré, nous avons utilisé l'approche endoscopique et un dispositif pour sectionner l'anneau gastrique.Résultats : L'anneau ou le tube s'est érodé chez 14 patients (12,7 %). L'intervalle médian entre la pose initiale de l'anneau gastrique et le diagnostic d'érosion a été de 32 (entre 18 et 52) mois. La douleur abdominale haute, l'infection du port d'accès, la diminution de la restriction et la reprise de poids ont été les symptômes les plus fréquents. Nous avons utilisé un dispositif pour sectionner l'anneau gastrique afin de retirer l'anneau par voie endoscopique. Le dispositif a permis de sectionner l'anneau avec succès chez tous les patients sauf 1; dans ce dernier cas, une torsion du fil à sectionner a nécessité la conversion de l'endoscopie en une laparotomie. Chez 2 patients, une fois sectionné, l'anneau est resté emprisonné dans la paroi gastrique et a nécessité une extraction laparotomique. Chez 1 patient, nous avons effectué une intervention chirurgicale en raison de la pénétration intragastrique de la tubulure de raccord sectionnée à proximité de l'anneau. Conclusion :Le dispositif servant à sectionner l'anneau gastrique a bien fonctionné chez tous les...

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Section: Discussionsupporting

confidence: 58%

Endoscopic management of gastric band erosions: a 7-year series of 14 patients

Doğan

Akın

Yalakı

et al. 2014

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“…The incidence of complications varies greatly between various series of cases. [5][6][7] Nevertheless, the rate of complications observed is generally decreasing with improvement in the learning curve. 7 Among the later complications noted is LAGB erosion, with an incidence varying between 0.6% and 11%, that ultimately requires extraction of the LAGB.…”

Section: Discussionmentioning

confidence: 99%

“…7 Among the later complications noted is LAGB erosion, with an incidence varying between 0.6% and 11%, that ultimately requires extraction of the LAGB. 5 LAGB erosion can be silent and rarely causes peritonitis, but it should be suspected in any patient with unexplained weight gain after initial weight loss or if wound infection develops at the port site. [5][6] The causes for LAGB erosion are poorly understood, but many recent theories explain why it is a less common complication compared with the initial LAGB procedures.…”

Section: Discussionmentioning

confidence: 99%

“…5 LAGB erosion can be silent and rarely causes peritonitis, but it should be suspected in any patient with unexplained weight gain after initial weight loss or if wound infection develops at the port site. [5][6] The causes for LAGB erosion are poorly understood, but many recent theories explain why it is a less common complication compared with the initial LAGB procedures. Meir and Van Baden 8 suggested four different etiologic hypotheses for LAGB erosion: (1) Abnormal reaction of the periprosthesic tissue in response to the presence of the LAGB, (2) infection of the band site, (3) excessive inflation of the band and consequent ischemia of the gastric wall, and (4) damage of the gastric wall during band implantation (caused by direct mechanical injury or a diathermy injury from electrocautery).…”

Section: Discussionmentioning

confidence: 99%

“…The complications that have been reported after LAGB are band slippage, band erosion, migration, pouch dilatation, infection at the port site, leakage, and outlet obstruction. [3][4][5][6][7] In our case, we present a patient presenting with small bowel obstruction secondary to LAGB that eroded into the stomach and migrated through the pylorus to the upper jejunum, resulting in a small bowel obstruction.…”

Section: Introductionmentioning

confidence: 99%

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Acute Presentation of Laparoscopic Gastric Band Erosion

Bawahab

2015

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Laparoscopic adjustable gastric band (LAGB) is a well-established bariatric surgical procedure. LAGB surgery is associated long term with a significant chance for reoperation within 10 years of band placement; 2 causes of reoperation are band migration and erosion. LAGB migration is a common late complication of gastric band, with a reported incidence of as much as 11%. Herein we present a patient with LAGB erosion presenting as small bowel obstruction. In our patient, the LAGB had completely eroded into the stomach and migrated through the pylorus to the upper jejunum, resulting in a small bowel obstruction. We describe our laparoscopic approach and management of this complication, which requires a high index of suspicion.

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