<TABLE class=tborder id=post652587 cellSpacing=0 cellPadding=6 width="100%" align=center border=0><TBODY><TR vAlign=top><TD class=alt1 id=td_post_652587 style="BORDER-RIGHT: #c9ced4 1px solid"><TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD></TD></TR></TBODY></TABLE>this was on another post Gary<HR style="COLOR: #c9ced4; BACKGROUND-COLOR: #c9ced4" SIZE=1>
Erosion is where the band erodes into the inside of the stomach.
The history of erosion:
Gastric band surgery started in Europe/Australia and they were using the peri-gastric technique (the band was placed lower on the stomach).
When they started seeing a high slip rate with this technique they started stitching the stomach over the top of the band to prevent all the slips they were seeing.
The problem was they were stitching the stomach really tightly over the band. When you have living tissue stretched tightly over a hard object (like band plastic) the tissue will be under so much tension that it won't have good blood flow and will necrose (dead tissue) over time and then the band works itself inside the stomach.
It doesn't erode into the stomach that the inner balloon is squeezing on, it erodes into the stomach that was wrapped so tightly over the top of the band.
Fortunately, the European/Australian surgeons changed the procedure to the pars flaccida technique (place the band much higher on the stomach) and they learned to wrap the stomach tissue much more loosely over the top of the band. This brought the erosion rate down from 10% to less than 1% and over time and with more experience erosions are now quite rare. Every U.S. surgeon that I know uses the new pars flaccida technique.
In our Seattle practice (2,500+band procedures) we had 2 erosions.
When you suspect an erosion on x-ray (fluoro) it is best to proceed with a scope (EGD - scope of the stomach) to make sure the band has indeed eroded, i.e. you can see white plastic from inside the stomach.
If the band has eroded, the treatment is to remove it, let everything heal for 3-6 months and then replace it.
The Australians have a fair bit of experience with this and report good results replacing a new band later. In the past they would put a new band in at the same operation that they removed the eroded band but the re-erosion rate was too high and they now recommend replacing it later.
Erosions vary. Some patients have a tiny erosion (can only see a small bit of the band from inside the stomach) that some surgeons will watch if the patient is still losing weight. I've heard of cases where the entire band erodes into the stomach and it was removed without surgery using a scope to retrieve it from inside the stomach. I have heard of cases where they tried unsuccessfully to remove the band from within the stomach.
Hope that is useful information
brad
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Gastric Band Surgeon since 2002
www.CincyWeightLoss.com
"There are no secrets to success. Don't waste time looking for them. Success is the result of perfection, hard work, learning from failure...and persistence." Colin Powell
Remember that every band patient's journey is individual and that reaching your goal is far more important than how long it took you to get there.
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