Lap Band Erosion

Erosion is the condition in which the band erodes away the stomach where the band and the stomach come in contact with one another, eventually resulting in a hole being worn in the stomach wall.

When lap band was new the erosion rate ran as high as 10 percent. This occurred primarily in Australia and Europe because they used the peri-gastric technique. This lower placement of the band caused a higher slippage rate. The solution to that was to stitch the stomach tightly over the band. Any time you have living tissue in contact with something artificial, in this case the lap band the tissue if under too much tension can't get proper blood flow. As the tissue dies, it can't resist the pressure of the band and it erodes into the stomach. Later on the Europeans and Australians realized they were causing the erosion with their technique and changed to the the pars flaccida technique which places the band much higher on the stomach. They also don't wrap the stomach tissue so tightly over the band so the tissue doesn't die and the band won't erode in. The erosion rate is now down to less than 1%.

How to you tell if you have lap band erosion?

One of the first signs is redness, swelling and pain around the access port. This is caused by bacteria from the stomach getting into the capsule that forms around the band. The infection simply travels to the outside port along the tubing. Another sign that erosion is happening is that the erosion causes the band to be less restrictive than before so you can eat more than before. A lot more than before.

Diagnosis of erosion

Usually it first shows up on an x-ray and the confirmation is doing an upper GI endoscopy. The band can be seen penetrating the stomach wall if you have erosion occurring. There is variance in degree of erosion in patients. There are documented cases in which the band has completely eroded into the stomach.

Treatment of erosion

Lap band erosion typically requires that the lap band and access port be removed. It is more critical to remove it quickly if the erosion has caused an infection near the access port. Once removed, the eroded part can heal. This takes three to six months. After the erosion heals, you can once again be banded. Sometimes instead of rebanding your surgeon may want to do a gastric bypass or duodenal switch rather than risk putting another band in place and having it erode as well. This is a choice for you and your surgeon to make

Avoiding erosion

What if anything can you do to avoid lap band erosion? Avoid carbonated beverages or any other food that can cause bloating of the stomach. This goes back to the original diet plan you did when you first got banded. You drank a lot of fluids, the idea being to not push the stomach into the band and let the stomach become accustomed to the pressure exerted by the band. Eroding is less likely if there is this initial break in phase after being banded.

Other types of lap band failure