Evolving pattern of laparoscopic gastric band access port complications

Obes Surg. 2012 Jun;22(6):863-5. doi: 10.1007/s11695-011-0567-y.

Abstract

Laparoscopic gastric banding (LGB) is the commonest bariatric procedure in Australia. The commonest complication of LGB is access port or tubing (AP/T) problems, requiring revisional surgery. The aim of this study was to document the evolving pattern of AP/T complications. All patients whose LGB procedure (Allergan(TM) Bands) and AP/T revision (Allergan(TM) port revision sets) were performed by one surgeon (1999 to 2008) were included, giving 167 AP/T revisions in 124 patients out of a total 1,928 LGB patients. All patient follow-up details were prospectively recorded and retrospectively analysed. Incidence of LGB AP/T problems was 8.7%. Mean time to first AP/T revision was 2 years. Over the last 4 years of the series, the number of LGB insertions was constant, but the number of AP/T revisions progressively increased. Twenty-seven percent of AP/T revision patients required two or more AP/T revisions. Sixty-two percent of the AP/T complications were leaks. Half the AP complications were flipping of the AP. There was no correlation of AP/T problems with any changes to port design to date. Infection rate for LGB insertion was 0.67%. The incidence of LGB AP/T complications progressively increases with duration after LGB insertion. Occurrence of one AP/T problem appears to select a subgroup more likely to experience further AP/T problems. To date, revisions of port design do not appear to have solved AP/T problems. Recent introduction of a significantly redesigned port may reduce AP/T failures.

MeSH terms

  • Anastomotic Leak / epidemiology
  • Anastomotic Leak / etiology*
  • Anastomotic Leak / surgery*
  • Australia / epidemiology
  • Female
  • Gastroplasty / adverse effects*
  • Humans
  • Incidence
  • Intestinal Obstruction / epidemiology
  • Intestinal Obstruction / etiology*
  • Intestinal Obstruction / surgery*
  • Laparoscopy / adverse effects*
  • Male
  • Middle Aged
  • Obesity, Morbid / complications
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery*
  • Reoperation
  • Retrospective Studies
  • Time Factors
  • Treatment Failure