Adjustable gastric banding surgery is a surgical treatment for obesity meant for patients who have previously tried but failed to lose weight with diet and exercise alone. During the procedure, a plastic band is placed around the upper part of the stomach, creating a smaller pouch. The surgical device includes a thin, hollow silicone rubber ring accompanied by a small tube. The band is implanted deflated and it is later inflated with saline solution, adjusting the opening of the stomach.
This type of surgery works by restricting the amount of food and caloric intake, allowing patients to feel fuller more quickly and consume fewer calories, aiding in weight loss. The tube includes a small port that is positioned just below the skin and is used to adjust the band whenever needed and recommended by the physician. Despite its effectiveness, there are numerous complications that may occur, including gastric band erosion.
What Is Gastric Band Erosion and How do you Identify It?
Gastric band erosion, otherwise known as band migration, is when the gastric band placed during adjustable gastric banding surgery grows into the stomach. It is a problem for patients, since it will no longer restrict food and it can cause further complications. The first signs of gastric band erosion are increased feelings of hunger and weight gain. In addition, patients can also experience port site skin infection, port site abscess and/or the need to overfill the band.
Gastric band erosion is a potential long-term complication, however, it is very rare during the first two years after the surgery. Patients can help in early diagnosis by seeking out help right after noticing unexpected alterations in hunger or weight, or if they notice that the band is being overfilled in comparison with previous fillings. If any of these signs is verified, a physician will confirm the gastric band erosion with an upper gastrointestinal endoscopy, which means that a scope is inserted through the mouth into the stomach to allow direct vision.
Gastric Band Erosion Treatment and Correction
“Laparoscopic adjustable gastric banding (LAGB) is an effective treatment for morbid obesity. The complications reported for LAGB are infections of the port site, band slippage, pouch dilatation, and intragastric band migration or band erosion. Gastric band erosion has a highly reported incidence of 0.3 to 14%. Erosion usually presents as a late complication (1–3 years after intervention) but some series report erosion within the first weeks. Early erosion is generally a technical problem due to unrecognized gastric perforation during surgery or an early infection,” as explained in the study “Removal of Eroded Gastric Bands Using a Transgastric SILS Device.”
Gastric band erosion may also be related to gastric wall ischemia secondary to a tight band, peptic ulcer perforation, implantation of a contaminated device, binge eating, and purging. The same study revealed that the best managed for gastric band erosion is endoscopic removal. “Recent case studies reported successful endoscopic removal of intragastric migrated bands, but it is not always possible. The timing of removal is still unclear.” In addition, patients are advised to wait at least three months prior to inserting a new band.