Technical Details and Result of a Minimally Invasive Management of Gastric Band Erosions: a Series of 47 Patients

  • Niccolò FurbettaEmail author
  • Francesca Gragnani
  • Rosa Cervelli
  • Francesco Guidi
  • Francesco Furbetta
New Concept



Laparoscopic adjustable gastric banding (LAGB) is proven to be a safe and effective treatment option for obesity in the long term. However, in recent decades, LAGB prevalence progressively decreased worldwide principally due to the incidence and the management of the complications. Understanding the optimal management of the complications becomes therefore of primary importance. The aim of this study is to describe a personal technical, laparoscopic solution of band erosion and to analyze outcomes in 47 patients.


From October 1995 to January 2019, 3697 LAGB were performed at our institution. Since November 2011, an original laparoscopic gastric banding removal technique was introduced. All the bands placed in these patients were Lap-Band AP System (Allergan, Irvin, CA). The data of the patients who underwent gastric band removal because of band erosion were retrieved from a prospectively collected institutional database, and used for the present retrospective evaluation.


Ninety-four patients (2.5% of the entire casuistic) with eroded band were diagnosed and treated at our institution. Forty-seven patients were treated with the laparoscopic gastric banding removal technique introduced in November 2011. All the operations have been performed laparoscopically with no conversion or intraoperative complications. There were neither major complications nor peri-operative (30 days) mortality.


Proper preoperative management and a standardized minimally invasive technique could help to cope with erosion, the most frightening complication of LAGB. Understanding the optimal management of complications and safe reoperation techniques can contribute to a rational use of the LAGB, reversing the current declining tendency.


Laparoscopic adjustable gastric banding Erosion Minimally invasive surgery Complications Laparoscopic gastric band removal 


Compliance with Ethical Standards

Conflict of Interest

Dr Furbetta Niccolò, Dr Gragnani Francesca, Dr Cervelli Rosa, and Dr Guidi Francesco have no conflicts of interest or financial ties to disclose. Dr Furbetta Francesco reports personal fees from Apollo Endosurgery, outside the submitted work.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    O’Brien PE, MacDonald L, Anderson M, et al. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg. 2013;257:87–94.CrossRefGoogle Scholar
  2. 2.
    O’Brien PE, Hindle A, Brennan L, et al. Long-term outcomes after bariatric surgery: a systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-year outcomes after adjustable gastric banding. Obes Surg. 2018;12Google Scholar
  3. 3.
    Furbetta N, Gragnani F, Flauti G, et al. Laparoscopic adjustable gastric banding on 3566 patients up to 20-year follow-up: long-term results of a standardized technique. Surg Obes Relat Dis 2019;15:409–16.Google Scholar
  4. 4.
    English WJ, DeMaria EJ, Brethauer SA, et al. American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016. Surg Obes Relat Dis. 2018;14:259–63.CrossRefGoogle Scholar
  5. 5.
    Brown WA, Egberts KJ, Franke-Richard D, et al. Erosions after laparoscopic adjustable gastric banding: diagnosis and management. Ann Surg. 2013;257:1047–52.CrossRefGoogle Scholar
  6. 6.
    Ponce J, Fromm R, Paynter S. Outcomes after laparoscopic adjustable gastric band repositioning for slippage or pouch dilation. Surg Obes Relat Dis. 2006;2:627–31.CrossRefGoogle Scholar
  7. 7.
    Di Lorenzo N, Lorenzo M, Furbetta F, et al. Intragastric gastric band migration: Erosion: an analysis of multicenter experience on 177 patients. Surg Endosc Other Interv Tech. 2013;27:1151–7.CrossRefGoogle Scholar
  8. 8.
    Singhal R, Bryant C, Kitchen M, et al. Band slippage and erosion after laparoscopic gastric banding: a meta-analysis. Surg Endosc. 2010;24:2980–6.CrossRefGoogle Scholar
  9. 9.
    Owers C, Ackroyd R. A study examining the complications associated with gastric banding. Obes Surg. 2013;23:56–9.CrossRefGoogle Scholar
  10. 10.
    Egberts K, Brown WA, O’Brien PE. Systematic review of erosion after laparoscopic adjustable gastric banding. Obes Surg. 2011;21:1272–9.CrossRefGoogle Scholar
  11. 11.
    Quadri P, Gonzalez-Heredia R, Masrur M, et al. Management of laparoscopic adjustable gastric band erosion. Surg Endosc Springer US. 2017;31:1505–12.CrossRefGoogle Scholar
  12. 12.
    Echaverry-Navarrete DJ, Maldonado-Vázquez A, Cortes-Romano P, et al. Banda gástrica penetrada. Una alternativa de tratamiento. Cir Cir (English Ed. Academia Mexicana de Cirugía A.C. 2015;83:418–23.Google Scholar
  13. 13.
    Kohn GP, Hansen CA, Gilhome RW, et al. Laparoscopic management of gastric band erosions: a 10-year series of 49 cases. Surg Endosc Other Interv Tech. 2012;26:541–5.CrossRefGoogle Scholar
  14. 14.
    Chisholm J, Kitan N, Toouli J, et al. Gastric band erosion in 63 cases: endoscopic removal and rebanding evaluated. Obes Surg. 2011;21:1676–81.CrossRefGoogle Scholar
  15. 15.
    Mozzi E, Lattuada E, Zappa MA, et al. Treatment of band erosion: feasibility and safety of endoscopic band removal. Surg Endosc Other Interv Tech. 2011;25:3918–22.CrossRefGoogle Scholar
  16. 16.
    Dogan ÜB, Akin MS, Yalaki S, et al. Endoscopic management of gastric band erosions: a 7-year series of 14 patients. Can J Surg. 2014;57:106–11.CrossRefGoogle Scholar
  17. 17.
    Cherian PT, Goussous G, Sigurdsson A. Management of band erosion with omental plugging: case series from a 5-year laparoscopic gastric banding experience. Obes Surg. 2009;19:1409–13.CrossRefGoogle Scholar
  18. 18.
    Baldinger R, Mluench R, Steffen R, et al. Conservative management of intragastric migration of Swedish adjustable gastric band by endoscopic retrieval. Gastrointest Endosc. 2001;53:98–101.CrossRefGoogle Scholar
  19. 19.
    Cherian PT, Goussous G, Ashori F, et al. Band erosion after laparoscopic gastric banding: a retrospective analysis of 865 patients over 5 years. Surg Endosc. 2010;24:2031–8.CrossRefGoogle Scholar
  20. 20.
    Abu-Abeid S, Zohar DB, Sagie B, et al. Treatment of intra-gastric band migration following laparoscopic banding: safety and feasibility of simultaneous laparoscopic band removal and replacement. Obes Surg. 2005;15:849–52.CrossRefGoogle Scholar
  21. 21.
    Angrisani L, Di Lorenzo N, Favretti F, et al. The Italian Group for LAP-BAND: predictive value of initial body mass index for weight loss after 5 years of follow-up. Surg Endosc. 2004;18:1524–7.CrossRefGoogle Scholar
  22. 22.
    Calmes JM, Giusti V, Suter M. Reoperative laparoscopic Roux-en-Y gastric bypass: an experience with 49 cases. Obes Surg. 2005;15:316–22.CrossRefGoogle Scholar
  23. 23.
    Vertruyen M, Paul G. 11-cm Lap-Band System placement after history of intragastric migration. Obes Surg. 2003;13:435–8.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.General Surgery, Department of SurgeryUniversity of PisaPisaItaly
  2. 2.General and laparoscopic SurgeryLeonardo ClinicSovigliana-Vinci (Florence)Italy
  3. 3.Diagnostic and Interventional RadiologyUniversity of PisaPisaItaly

Personalised recommendations