THE DEVELOPMENT OF MIGRATION IN LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING AND THE APPROACH TO TREATMENT

Objective: Laparoscopic adjustable gastric banding (LAGB) application in the treatment of morbid obesity has many advantages. However, certain complications, such as intragastric migration, may occur. In the present study, the effects of such migration and surgical treatment methods were investigated. Methodology: One hundred thirty-four patients underwent LAGB via the Pars Flaccida technique. Of the patients mean age was 27 years ( 18-54 ). Migration was suspected based on disappearance of the band-related stricture barium contrast examination of the stomach and duodenum. Migration was definitely diagnosed during gastroscopy. Results: Migration was diagnosed in four (3%) of 134 patients, as well as in one case who underwent LAGB in another center. The follow-up time was 14 months (2-21) and, their mean body mass index (BMI) was 47 kg/m2 (39-56). The band was removed in four patients, the opening formed in the stomach was sutured primarily. One of the patients underwent cholecistectomy and Roux-en-Y gastroenterostomy (RNYGE). Conclusions: The development of migration after LAGB is a long-term complication. Gastric bands should be removed as soon as the migration is diagnosed. RNYGE in the same session, or new band application 3-6 months later.