Outcome and Complications after Laparoscopic Swedish Adjustable Gastric Banding: 5-Year Results of a Prospective Clinical Trial

Abstract

At 5-year follow-up, laparoscopic SAGB is a safe and effective surgical treatment for morbid obesity. Our results appear to confirm that SAGB is a safer surgical treatment regarding rate and severity of complications compared with gastric bypass and malabsorptive procedures.

Past, present, and future: Critical analysis of use of gastric bands in obese patients

“…[59][60][61][62][63][64][65][66][67][68][69][70] Band slippage or band prolapse occurs when part of the stomach herniates through the band at the top of the stomach. This occurs in about 4% (1.0%-6.5%) of patients in recent studies, with older studies showing a much higher rate of this complication.…”

The Gastric Banding

“…Intraoperative complications (⊡ Table 17.2) include: ▬ Esophageal or gastric wall injury due to the use of coagulation or too "brutal" attempts at passage behind the stomach [11,14,15] ▬ Gastric bleeding, usually easy to control. The management of this complication is simpler, of course, if the source of bleeding is visible and much more difficult in the case of bleeding involving the adipose tissue or situated in the posterior gastric wall.…”

Acute Presentation of Laparoscopic Gastric Band Erosion

“…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.…”

“…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).…”

“…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.…”