Slippage-a Significant Problem Following Gastric Banding-a Single Centre Experience

Laparoscopic adjustable gastric banding is a well-established method of morbid obesity treatment. One of the complications is slippage.

The aim of the study was to assess the prevalence, causes, and handling of slippage after LAGB in own material.

There were 740 procedures performed by one surgical team. The patients were selected according to the IFSO principles. The pars flaccida technique was applied and the position of the band was controlled. There was neither plication nor the bands were sutured to the stomach wall. Slippage was recognized during X-ray examination. With these patients, the band was emptied of liquid, gastric endoscopy was performed routinely, and patients were qualified for surgery.

The patient group consisted of 500 women and 240 men. The average body weight was 128 kg and BMI 44.60 kg/m². The slippage was observed in 8.1% cases in 7.03% patients. In 1.08%, slippage occurred twice. The main problems reported by patients were pain, a significant increase of disposable food intake, vomiting, and weight gain. In a small group of patients, these complications were detected incidentally. All patients were treated surgically. In 38.33%, the band repositioning was performed. In 33.33%, a different surgical approach was performed. In the group of reoperated patients, there were no fatal cases or any severe complications.

In conclusion, we believe that slippage is and will continue to be a significant problem in patients with gastric banding. Patient education focused on dietary errors may reduce the incidence of this complication. The grace period between the primary surgery and the redo operation should be applied regarding reoperation.