Band Erosion

Band erosion is one of the problems with Lap-Band, but fear not this complication occur in less than 2% of patients when surgeons use present day technique. It was significantly more common early on when the band was placed tightly against the stomach.

Symptoms/Presentation

When the band erodes into the stomach, bacteria from the stomach enter into the capsule that mutually forms around the band. The infection then travels along the tubing into the pocket around the subcutaneous port. Thus many patients who develop erosion first notice pain, redness, and swelling in the vicinity of the access port. Another way that band migration presents is the loss of the band's restrictive effect. When the band erodes well into the stomach, food can bypass around the band. The patient can eat much more than before

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It is best diagnosed with upper GI endoscopy. The endoscopist can actually see the band as it penetrates the stomach wall. An eroded band can sometimes be identified by CT scan.

Treatment

Erosion is usually not an emergency. If the access port site is infected, the port must be removed promptly. Removal of an eroded band can be a difficult procedure requiring an open approach. Most surgeons simply remove the band and then perform rebanding, a gastric bypass, or some other procedure. In most cases, rebanding is successfully performed.

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