Obes Surg. 2005 Aug;15(7):1050-4.
Reduction in slippage with 11-cm Lap-Band and change of gastric banding
Wolnerhanssen B, Kern B, Peters T, Ackermann C, von Flue M, Peterli R.
Surgical Clinic, St. Claraspital, Basel, Switzerland.
Slippage occurs after 2-18% of gastric bandings performed by
the perigastric technique (PGT). We investigated the slippage-rate
before and after the introduction of the pars flaccida technique (PFT)
and the 11-cm Lap-Band, and the long-term results of the re-operated
patients. METHODS: Between Dec 1996 and Feb 2004, 360 patients with a
mean BMI of 44 kg/m2 were operated. The PGT (n=168) and PFT9.75 (n=15)
groups received the 9.75-cm Lap-Band, and the PFT11 group (n=177)
received the new 11-cm Lap-Band. Follow-up rate was 99%. RESULTS:
Slippage occurred in a total of 31 patients from all groups (PGT, n=28,
or 17%; PFT9.75, n=1, or 7%; PFT11, n=2, or 1%). Average yearly
re-operation rate for slippage in the first 3 years postoperatively was
3.8%, 2.2% and 0.9%, respectively. Laparoscopic re-banding was necessary
for posterior (n=19) or lateral (n=12) slippage. The late postoperative
course after re-banding was: uneventful 58%, weight regain 35% and/or
esophageal motility disorder 23%, secondary band intolerance 20%, and
one persistent posterior slippage. 8 patients (26%) needed
CONCLUSION: Since the introduction of the PFT
and the 11-cm Lap-Band, we observed a significant reduction in slippage
rate and no posterior slippage. Re-banding had a less favorable
long-term result than did first-procedure banding.