CONVERSIONS AND COMPLICATIONS IN 185 LAPAROSCOPIC ADJUSTABLE SILICONEGASTRIC BANDING CASES

Background: Kuzmak's gastric silicone banding technique is the least i nvasive operation for morbid obesity. The purpose of this study was to analyze the complications of this approach. Methods: Between Septembe r 1992 and March 1996, 185 patients underwent laparoscopic gastroplast y by the adjustable silicone band technique, A minimally invasive proc edure using five trocars was performed. Results: In 11 patients exposu re of the hiatus was impeded because of hypertrophy of the left liver lobe which led to conversion in eight patients and abortion of the pro cedure in three other patients. Anatomical complications: We observed two gastric perforations and one band slippage at the early stage, one infection and three rotations of the access port. Functional complica tions: There were eight (4%) cases of irreversible total food intolera nce resulting in pouch dilation and eight cases (4%) of esophagitis. O ne fatality on the 45th day in a patient with a Prader-Willi syndrome. Conclusion: The most disturbing complications of gastric banding tech nique are gastric perforation and pouch dilation. Their incidence may be reduced by improving the technique and by considering pitfalls of t he procedure.