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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
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Abstract

Introduction

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.

Methods

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.

Result

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.

Conclusion

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.

Keywords

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

Notes

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.

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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

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