Pathologic Changes in the Stomach at the Site of Silicone Gastric Banding

Silicone gastric banding procedures for severe obesity have been done on 303 patients; 214 as primary operations and 89 as revisions of different types of gastric restriction operations. Twenty-five bands were removed, and in 16 of these cases full thickness gastric wall biopsies were done at the banding site. The pathologic changes at the banding site in these 16 patients consisted of variable local tissue responses consistent with constriction due to the banding process. The most significant finding, seen in only one patient, was full thickness fibrous replacement of the muscular wall. Ten patients had only serosal fibrosis at the banding site and four had both serosal fibrosis and patchy fibrous replacement of the muscularis propria. One biopsy specimen showed no pathologic changes. Notably absent in all cases were evidence of ischemia and evidence of penetration of the gastric wall by the band.