Treatment of Intra-Gastric Band Migration Following Laparoscopic Banding: Safety and Feasibility of Simultaneous Laparoscopic Band Removal and Replacement

Abu‐Abeid, Subhi; Zohar, Dan Bar; Sagie, Boaz; Klausner, Joseph M.

doi:10.1381/0960892054222696

Cited by 64 publications

(48 citation statements)

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“…Without the restriction of the band, most patients regained weight and gastric bypass or biliopancreatic diversion or sleeve gastrectomy was proposed [29][30][31][32]. Some surgeons started to remove the band via laparoscopy and place another band during the same session or several weeks later [33][34][35]. Initially, This was done for intragastric migration of band positioned via the perigastric pathway; pars flaccida positioning was used for the second band.…”

Section: Discussionmentioning

confidence: 99%

Intragastric gastric band migration: erosion: an analysis of multicenter experience on 177 patients

Lorenzo

Furbetta

et al. 2012

Surg Endosc

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Background Laparoscopic adjustable gastric banding (LAGB) has proven to be a safe and effective surgical treatment for morbid obesity. It can be a simple, fast, reversible, anatomy-preserving procedure. Despite these advantages, its long-term efficacy came into question by the occurrence of complications such as intragastric band migration. Consistent information regarding this complication is still lacking. Treatment for migration is still being debated as well. Most of the inconsistencies of these data stem from the very low number of patients reported in single-center experiences or case reports. Lack of multicenter experience is evident. The aim of this study was to perform a retrospective analysis of data on intragastric migration in a large multicenter cohort of patients who underwent LAGB. Methods A retrospective multicenter study on LAGB patients was performed. Data had been entered into a prospective database of the Italian Group for LapBand Ò (GILB) since January 1997. Pars flaccida and perigastric positioning were considered along with different kinds of gastric bands by the same manufacturer. Time of diagnosis, mean body mass index (BMI), presentation symptoms, and conservative and surgical therapy of intragastric migration were considered. Results From January 1997 to December 2009, a total of 6,839 patients underwent LAGB and their data were recorded [5,660 females, 1,179 males; mean age 38.5 ± 18.2 years (range 21-62 years); mean BMI = 46.7 ± 7.7 kg/m 2 (range 37.3-68.3); excess weight (EW) 61.8 ± 25.4 kg (range 36-130); %EW 91.1 ± 32.4 % (range 21-112 %)]. A total of 177 of 6,839 (2.5 %) intragastric erosions were observed. According to the postoperative time of followup, the diagnosis of intragastric migration was made in 74 (41.8 %), 14 (7.9 %), 38 (21.4 %), 40 (22.6 %), 6 (3.4 %), and 4 (2.2 %) banded patients at 6-12, 24, 36, 48, 60, and 72 months after banding, respectively. Most of intragastric band migration during the first 2 years occurred in bands with no or a few milliliters of filling. In patients with late erosion, the bands were adjusted several times; no band was overfilled but one was filled to the maximum or submaximum with a maximum of two adjustments. Erosions diagnosed during the first 24 months were related to the experience of the surgical staff, while late erosions were not. Conclusions Intragastric band migration or band erosion is a rare, disturbing, and usually not life-threatening complication of gastric banding. Its pathogenesis is probably linked to different mechanisms in early (technical failure in retrogastric passage) or late (band management) presentation. It is usually asymptomatic and there is no pathognomonic presentation. A wide range of therapeutic options are available, from simple endoscopic or laparoscopic removal to early or late band replacement or other bariatric procedure. More experience and more studies are needed to lower its presentation rate and definitively clarify its pathogenesis to address the right therapeutic option.

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Section: Discussionmentioning

confidence: 99%

Intragastric gastric band migration: erosion: an analysis of multicenter experience on 177 patients

Lorenzo

Furbetta

et al. 2012

Surg Endosc

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“…17 Bant migrasyonu tanısı konan hastada gastrik bandın çıkarılması ve revizyon cerrahisi için bir endikasyonu görülmektedir. 13,17,18 Geç poş dilatasyonu nedeniyle revizyon cerrahisi %18,9 oranında 4 yıl içerisinde, port enfeksiyonu %2,6 ile 3 yıl içersinde yapılmaktadır. Poşta meydana gelen dialtasyon ve enfeksiyon intragastrik basıncı artır-makta bunu sonucu migrasyona zemin hazırla-maktadır.…”

Section: Olgu Sunumuunclassified

“…20 Sonuç olarak LAGBU yapılan hastalarda bant migrasyonu geç dönem komplikasyonudur. Kilo kaybı durağanlaşan, asemptomatik veya port üze-rinde kronik enfeksiyonu olan hastalarda bant migTurkiye Klinikleri J Med Sci 2012;32 (4) …”

Section: Olgu Sunumuunclassified

“…5 Gastrik perferasyon ve kanama, gastro-gastrik fistül, poş dilatasyonu, özefagial dilatasyon ve motilite bozukluğu, gıda intolerasnı ve intragastrik bant migrasyonu (erozyon) diğer bantla ilgili komplikasyonlardır. 4,6,7 Lümen içine migrasyona neden olan gastrik erozyon önemli komplikasyonlardan bir tanesidir. Gastrik erozyon oranı değişik serilerde %1-11 oranında rapor edilmiştir.…”

unclassified

“…Gastik duvar erozyonu ve sonrasında olan bant migrasyonu lokalize minimal enfeksiyonla beraberdir. 13 Geç gastrik duvar erozyonundan iki mekanizma sorumludur; gastrik duvara uygulanan artmış basınç ve bandın yol açtığı yabancı cisim reaksiyonu.…”

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Migration of an Adjustable Gastric Band Into Gastric Lumen: A Rare Complication of Bariatric Surgery: Case Report

Yilmaz¹,

Alptekin²,

Şahin³

et al. 2012

Turkiye Klinikleri J Med Sci

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aparoskopik ayarlanabilir gastrik bant uygulaması (LAGBU) morbid obezitenin tedavisinde sıklıkla kullanılan bir prosedurdür, son zamanlarda dünyada en sık yapılan bariatrik operasyondur.1 LAGBU morbid obezite tedavisindeki ilk minimal invaziv uygulamadır. Çok düşük morbidite ve hemen hemen hiç mortalite ile karşılaşmadan morbid obezitenin efektif tedavisine olanak sağlar. ). An expansion was detected in proximal pouche on fluoroscopic examination when she was investigated for the complaint of epigastric pain in March 2010. A revision surgery was planned with the prediagnosis of band sliding. Total migration of the band into lumen and towards terminal ileum was detected on operation. The band was removed with enterotomy and a vertical band gastroplasty was performed. This is the first case in literature that the band lost its connection with the tube and migrated into the lumen of terminal ileum. If the band is migrated into distal parts as in this case, early surgery must be planned for preventing complications as ulceration, perforation and obstruction.

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Long‐Term Surgical Complications of Bariatric Surgery

Yunus¹,

Jan²

2022

Handbook of Metabolic and Bariatric Surgery

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Treatment of Intra-Gastric Band Migration Following Laparoscopic Banding: Safety and Feasibility of Simultaneous Laparoscopic Band Removal and Replacement

Abstract: 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.

Cited by 64 publications

References 9 publications

Intragastric gastric band migration: erosion: an analysis of multicenter experience on 177 patients

Intragastric gastric band migration: erosion: an analysis of multicenter experience on 177 patients

Migration of an Adjustable Gastric Band Into Gastric Lumen: A Rare Complication of Bariatric Surgery: Case Report

Long‐Term Surgical Complications of Bariatric Surgery

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