Leakage of adjustable gastric bands

Background: Surgery for morbid obesity has increased since the introduction of the adjustable gastric bands. Their advantage is the adjustability of t he band, which can be inflated or deflated percutaneously according to weig ht loss without altering the anatomy of the stomach. We present 5 cases of leakage of the Swedish adjustable gastric band (SAGB) as a result of tearin g of the balloon. Methods: In our series, 29 patients received an SAGE; the remaining 20 rece ived the LapBand(R). All but 4 procedures were performed laparoscopically. The adjustable gastric band (AGB) was inflated according to passage seen on gastro-esophagogram. According to weight loss or complaints of passage, th e gastroesophagogram was repeated, and the AGB was inflated or deflated. Results: No major complications were observed postoperatively. All but 5 pa tients showed weight loss and restriction of food intake after filling of t he AGE. These 5 patients had all received an SAGE. High-pressure filling wi th contrast medium showed leakage of the SAGE. After removal the SAGE, 4 sh owed a tear at the site of fixation of the balloon to the band, and 1 showe d a puncture of the balloon. The tears most probably occurred as a result o f inadequate fixation while the SAGE was positioned around the stomach. Conclusion: To our knowledge, this complication has not been described befo re. The manufacturer of the SAGE has been notified, and consequently the fi xation site has been reinforced.