Italian Collaborative Study Group: Features of intragastric band migration (erosion) for past 7 years

Purpose: Intragastric band migration (IGBM) erosion is the partial or complete penetration of the silicone band through the gastric wall. We report the data analysis of this infrequent complication in the 27 centers of the Italian Collaborative Study. Methods: The data from patients implanted with the Lap-Band System from January 1996 to July 2004 and diagnosed with IGBM erosion were collected and analyzed. The incidence, symptoms, time of presentation, treatment, follow-up, and complications are reported. The data are expressed as the mean 􏰁 standard deviation. Results: Of 3914 patients, 68 (1.7%) (13 men and 55 women; mean age 35.6 􏰁 8.5 years, range 18 – 60; mean body mass index 35.1 􏰁 7.4 kg/m2, range 18.3–58.6; excess weight loss 39 􏰁 18.7 kg, range 􏰄15 to 100; percentage of excess weight loss 72.4% 􏰁 39.8%, range 􏰄23% to 143%) developed IGBM erosion. Diagno- sis was made at 21.5 􏰁 13.6 months (range 3–57) from band placement. In 35 patients, IGBM erosion was diagnosed during the first year from surgery in 12, 15, and 6 patients, the diagnosis was made at 13–24, 25–36, and 􏰃37 months, respectively. Of the patients reporting IGBM erosion 11 (16.1%) had port infection. In 4 patients (5.8%), IGBM erosion was associated with gastric pouch dilation and with gastric perforation in 1 patient (1.4%). Of the 68 patients, 46 (67.6%) underwent band removal, 22 (32.4%) received band deflation and were strictly followed. Band removal was performed via laparoscopy in 41 (89.1%), laparotomy in 3 (6.5%), and endoscopy in 2 (4.4%). Mortality was absent. Conclusions: Erosion is a rare complication with the Lap-Band System. No mortality resulted. Erosion is a nonurgent complica- tion with several optional minimally invasive treatments. Parietal injuries during retrogastric wall dissection are highly suggestive of the development of this rare complication.