Banding Complications & Risks
Possible complications
Infection and migration
An infection may develop either in the port area or in the abdomen, and in some instances this may cause the band to migrate into the stomach. In such a case, reoperation normally is necessary. Most of the complications linked to migrations have occurred as a result of too much fluid being injected into the SAGB. The balloon must therefore be filled with no more than 9 ml of fluid, as recommended by the manufacturer. In nearly all of the reported cases of migration the balloon had a fluid content above 11ml. This is 2ml more than the recommended maximum volume. The rate of migration will be kept low by avoiding overfilling of the system. Migration can also be caused by a subclinical infection. Even if this is very rare, it is important that you do not let anyone inject liquid into your port without previously applying a swab soaked in 5% chlorhexidine spirit onto the skin for approximately ten minutes before the injection. Omitting skin preparation may result in an infection.
Leakage
Leakage from the SAGB or from the connecting tube between the balloon and the port may require reoperation. The balloon is made of fragile material, and leakage can occur either shortly after surgery or many years later. In the event of leakage, the SAGB can normally be easily replaced with a new one. Nowadays this is a rare complication, but you must be aware that there is a possible risk that in the long term the band may need to be replaced with a new one.
Slippage of the band and pouch dilatation
The band may slip, and the pouch (the part of the stomach above the band) may become too enlarged, and a reoperation may be necessary.
Punctures in the silicone band and port dislocation
- The injection port may dislocate.
- When injecting into the port, there is always the risk of puncturing the silicone tube.
However, should either of the above occur, both can easily be corrected with a small operation under local anaesthesia.
Other complications
Other complications have occurred. You should ask your doctor for more detailed information.
There is no guarantee that the SAGB will work without fault for the rest of your life; however, the SAGB has been in clinical use since 1987.
The risk of reoperation will always exist, even if none of the above-mentioned complications occur. You must understand that the possibility of reoperation is an integral part of the overall management of morbid obesity. Reoperations are considered a technical measure that is sometimes necessary.
As with any surgical procedure using general anaesthesia, there is, of course, a risk of complications with even the possibility of death. Please ask your doctor for more detailed information.
General Advice And Possible Minor Side-effects
Vomiting
Patients may vomit or feel pain after food intake. This can be caused either by a poor eating behaviour, or by the narrowing of the SAGB following the injection of fluid into the balloon. By eating slowly and calmly, you will learn to listen to the signals from your stomach. Regular vomiting is definitely a warning sign. In such cases, the amount of liquid in your SAGB may need to be readjusted.
Vitamins
During the phase of rapid weight reduction, vitamin supplements are advisable. A liquid vitamin mixture containing multivitamins, in particular the vitamin B complex, is recommended for at least the first 6 months following surgery.
Pregnancy
The period between surgery and weight stabilisation is considered to be a period of starvation. It is not advisable to become pregnant during starvation, despite the fact that the foetus has priority over the mother with regard to food. Should you nevertheless get pregnant, it is advisable to remove all the fluid from the balloon. You should wait until your weight has stabilised before becoming pregnant.
Medication
Tablets must be broken down into small pieces or crushed before they are taken. Patients should consult thier doctor about this matter.
Constipation
Many patients feel constipated after surgery. This is mainly because the reduced food intake leads to less faeces and thus fewer bowel movements. If laxatives become necessary, it is advisable to abstain from so-called bulking agents and instead use liquid laxatives, such as lactulose.
Doctor appointments
After surgery you must undergo regular check-ups as an outpatient. Generally, these check-ups will be carried out monthly, but soon visits should become less frequent. The SAGB will gradually be filled via the injection port during the first 18 months following surgery. During this period, your weight loss and level of well-being will be monitored. Once your weight has stabilised, check-ups will be necessary only when problems occur or on an annual basis.
