ArticlesLaparoscopic Adjustable Silicone Gastric Banding: Prospective Evaluation of Intragastric Migration of the Lap-BandSilecchia, Gianfranco MD, PhD; Restuccia, Angelo MD; Elmore, Ugo MD; Polito, Domenico MD; Perrotta, Nicola MD; Genco, Alfredo MD; Bacci, Vincenzo MD; Basso, Nicola MDAuthor Information From the Dipartimento di Chirurgia “Paride Stefanini” (GS, AR, UE, NP, AG, NB) and the Istituto Terapia Medica Sistematica (VB), Università “La Sapienza” Rome, Italy; Divisione Chirurgia (DP), Ospedale di Zagarolo, ASL RM G, Rome, Italy. Received January 12, 2001; accepted May 15, 2001. This study was partially supported by grant of the Italian Ministry of Education and Research. Address correspondence and reprint requests to Dr. Gianfranco Silecchia, Dipartimento di Chirurgia “P. Stefanini,” Policlinico “Umberto I,” Università “La Sapienza,” Viale del Policlinico, 161 00187, Rome, Italy. Address electronic mail to gianfranco.silecchia@ uniroma1.it Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: August 2001 - Volume 11 - Issue 4 - p 229-234 Buy Abstract Intragastric prosthesis (Lap-Band, BioEnterics Co., Carpinteria, CA, U.S.A.) migration is one of the major long-term complications of laparoscopic adjustable silicone gastric banding. The causes, clinical signs, timing, and overall incidence of band entrapment have not been prospectively investigated in a large series. The purpose of this study was to assess prospectively the incidence of Lap-Band intragastric migration and to establish the safety and effectiveness of minimally invasive band removal. Between January 1996 and June 2000, 148 consecutive patients enrolled in a multidisciplinary bariatric program underwent laparoscopic adjustable silicone gastric banding. In the follow-up treatment, gastrointestinal endoscopy was performed routinely. One hundred twenty-three patients with a minimum follow-up period of 12 months were entered into the study group. Eleven (9.2%) patients had long-term major complications. Intragastric band migration was observed in nine (7.5%) patients. The diagnosis was established by routine endoscopy between 10 and 41 months after surgery. Five erosions occurred in the first 30 cases (learning curve period). In six patients, the band was removed by an intragastric endoscopic-assisted approach avoiding laparotomy. The remaining three patients are under endoscopic surveillance. The results of this study show that routine upper gastrointestinal endoscopy can discover asymptomatic band migrations early. Band erosion did not require emergency treatment and can be removed safely by a minimally invasive approach. Copyright © 2001 Wolters Kluwer Health, Inc. All rights reserved.