Uncommon intragastric migration of the Swedish adjustable gastric band

The aim of this study was to assess the incidence of intragastric migration of the Swedish adjustable gastric band (SAGB) and to evaluate the safety and effectiveness of gastroscopic band removal. Between January 1996 and December 2001, 454 patients (381 women, 73 men) underwent a laparoscopic SAGB operation. All data (age, gender, pre- and postoperative weight, time of weight gain, band filling status, endoscopic diagnosis of migration, total weight reduction) were prospectively collected in a computerized data bank. Out of the 454 SAGB operations, 14 (3.1%) intragastric band migrations were observed. The average preoperative weight was 122.2 kg and the average postoperative minimum weight was 80.4 kg. All 14 patients had unexplained weight gain on an average of 20 months after the operation. The average band filling status was 8.2 ml. In 12 patients, the band was removed endoscopically, avoiding laparotomy. The remaining 2 patients are under endoscopic surveillance. The mean operating time was 120 minutes. No peri- or postoperative complication was observed. Intragastric band migration is a rare complication and should be considered if a patient starts to regain weight. Migration does not require immediate therapy and therefore this complication could be safely treated endoscopically.