Disaster with a new type of band for gastric banding

Background: Laparoscopic gastric banding has become an established therapy for morbid obesity. Typical complications are band dislocation, pouch dilat ation and stomach slippage. A new type of adjustable silicone band with eye s for suture fixation was proposed to avoid these complications. The experi ence with this new kind of band is reported. Methods: Between April 1998 and August 1998, 15 morbidly obese patients wer e treated by laparoscopic adjustable gastric banding using a new band type (manufactured by MEDING, Heinsberg, Germany). The band was fixed by single sutures using the eyes at each side of the buckle. There were 13 women and 2 men, with mean age 34 (range 21-54) years and mean body-weight 138.6 (ran ge 113-213) kg. Results: Intraoperative complications did not occur. Postoperatively 8 pati ents (53%) had increasing capacity for food intake and 2 (13%) had uncharac teristic abdominal pain. Radiographs revealed band rupture in 13 of 15 pati ents 3-11 months postoperatively. These patients were operated laparoscopic ally using a new technique for band change. Now, a Lap-band(TM) (BioEnteric s, Carpinteria, CA, USA) was inserted and fixed to the ventral stomach with three sutures similar to a ventral fundoplication. Radiographic and clinic al follow-up have been uneventful in all patients until now. Conclusion: This series demonstrated: 1) the importance of clinical follow- up; 2) a material defect of a new band type; and 3) development of a new la paroscopic technique far band change.