Band erosion in patients who have undergone vertical banded gastroplasty -: Incidence and technical solutions

Objectives: To study the incidence of band erosion in patients who have undergone vertical banded gastroplasty and to describe the reparative techniques used. Design: A retrospective review case series. Setting. A university hospital-based tertiary referral center. Patients: Two hundred fifty consecutive morbidly obese patients who underwent vertical banded gastroplasty between 1987 and 1995. Main Outcome Measures: The development of band erosion into the stomach, reparative surgical techniques, and long-term weight loss control. Results: Band erosion developed in 7 (2.8%) of the patients. Two patients had symptoms 1 month after undergoing forced endoscopy. Six patients required reoperation. The operative findings included Z cases of "external" band erosion through the lesser curvature into the stomach and 4 cases of "internal" band erosion through the circular staple line. The surgical techniques used for repair depended on the radiological and endoscopic data and on the operative findings; the techniques included conversion into a gastric bypass, band replacement after the creation of a new stoma, and gastroplasty plus distal gastric bypass. There were no complications, and adequate longterm weight loss was achieved in all but 1 of the patients who underwent reoperation. Conclusion: Band erosion may be corrected using appropiate surgical techniques to allow for adequate longterm weight loss in patients who have undergone vertical banded gastroplasty.