Band erosion in patients who have undergone vertical banded gastroplasty: incidence and technical solutions.

OBJECTIVES To study the incidence of band erosion in patients who have undergone vertical banded gastroplasty and to describe the reparative techniques used. DESIGN A retrospective review case series. SETTING A university hospital-based tertiary referral center. PATIENTS Two hundred fifty consecutive morbidly obese patients who underwent vertical banded gastroplasty between 1987 and 1995. MAIN OUTCOME MEASURES The development of band erosion into the stomach, reparative surgical techniques, and long-term weight loss control. RESULTS Band erosion developed in 7 (2.8%) of the patients. Two patients had symptoms 1 month after undergoing forced endoscopy. Six patients required reoperation. The operative findings included 2 cases of "external" band erosion through the lesser curvature into the stomach and 4 cases of "internal" band erosion through the circular staple line. The surgical techniques used for repair depended on the radiological and endoscopic data and on the operative findings; the techniques included conversion into a gastric bypass, band replacement after the creation of a new stoma, and gastroplasty plus distal gastric bypass. There were no complications, and adequate long-term weight loss was achieved in all but 1 of the patients who underwent reoperation. CONCLUSION Band erosion may be corrected using appropriate surgical techniques to allow for adequate long-term weight loss in patients who have undergone vertical banded gastroplasty.