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Risks Specific to Laparoscopic Adjustable Gastric Band

Posted Jun 02 2009 4:39pm

The Lap-Band System is a much less complicated procedure than the other bariatric operations. Because of this, there are few potential complications possible immediately after placement of the Lap-Band System. There are some long-term complications possible that are unique.
Slippage
In order for the band to function properly it must be correctly positioned on the stomach. . The Lap-Band System can "slip". That is, the Lap-Band System can twist out of position. The band itself doesn’t usually slip, the stomach slips above the band. A slip occurs in 2 percent of patients. Slippage can occur for a variety of reasons; over filling resulting in persistent vomiting can be a culprit. Slippage can cause reflux and difficultly with foods. Weight loss can be affected. This can be diagnosed by an X-ray - however, only your surgeon will be experienced enough to diagnose this problem. Some slippages, if caught early can be corrected by removing all saline from the band and allowing the stomach to heal and then gradually re-filling to attain restriction. Slippage may require re-operation to reposition the band and in extreme cases band removal. If a band is removed for slippage it generally can be replaced after a healing period.
Band Erosion
The Lap-Band System has been known to erode into the stomach. Erosion is a rare complication more specific to some of the older design of bands. This occurs in 2 percent of patients. It is characterized by the stomach tissue over-growing around the band until the band is on the inside of the stomach instead of the outside. Erosion almost always necessitates band removal, sometimes surgical, although it rarely is a life-threatening situation.
Hardware Difficulties
Ports have been broken and tubing punctured usually during the filling process. This risk is diminished by using experienced fill practioners and using fluoroscopy to locate the port. However, broken ports and punctured tubing are relatively simple matters to fix although frustrating for the patient. The problem has been addressed with newer port designs.
Infection
With any surgical procedure or adjustment there is always the slight risk of infection. Infections can usually be treated with antibiotics and in rare cases may necessitate removal. Always make sure you are in top health prior to your surgery or adjustments without colds or drugs that may compromise your immune system. Notify your doctor immediately if you suspect you may have an infection of any type.
Stretched Pouch
This is a complication that can be completely avoided by not overeating. Learn to stop eating the moment you feel satisfied. Continuously packing food into your stomach when full will cause it to stretch and food may back up into your esophagus causing you future discomfort and problems.
Reflux
Reflux is frequently associated with a too tight band causing stomach fluids to back up into the esophagus and damage the delicate tissues not designed to be bathed in acidic stomach juices. If you are experiencing mild reflux talk to your doctor about preventative measures such as diet changes or medications. If your reflux is a persistent problem speak to him immediately, don’t complicate the issue by waiting hoping it will get better without intervention.

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