Injection port complications after gastric banding: incidence, management and prevention

Laparoscopic adjustable gastric banding is advocated as a minimal invasive procedure with a low risk profile and high efficacy in the treatment of morbid obesity. Nevertheless, injection port complications are occasionally reported. The aim of this study was to assess port disconnections and port dislodgement with respect to two different implantation techniques.

Between January 1996 and October 1999 230 patients underwent laparoscopic gastric banding with the Swedish Adjustable Gastric Band (SAGB). In group 1 (118 patients), the injection port was implanted onto the sterno-xiphoid union. In group 2 (112 patients), an additional incision was made to suture the port onto the fascia of the lower third of the sternum.

There is a significant reduction in port disconnection between group 1 (9.3 %) and group 2 (0 %). Port dislodgment was observed in one patient in each group. Reoperation was performed under local anesthesia in 11 patients, and general anesthesia was used for laparoscopic tube salvage in two patients. After reconnection, two patients experienced port infection.

Correct implantation technique of the injection port of the SAGB onto the fascia of the lower third of the sternum reduces the risk for port complications. Technical notes are discussed.