Can an Adjustable Gastric Band Develop a Leak?

If you do not feel restriction even after the band is adjusted repeatedly you could have a leak somewhere in the system.

Your surgeon may be able to determine that a leak has occurred by withdrawing the fluid from the band to see if the amount is about the amount that has been placed into the band over time. If necessary the radiologist or surgeon can inject contrast into the port and the x-rays can show where the system is leaking.

Actually it is quite rare to find a leak in a gastric band system. In fact I have only had this happen a couple of times over the years I have been placing gastric bands and in each occurrence it has been a leak from the tubing from where the access needle had punctured the tubing. To date this has only happened with the Lap-Band system in my practice. However, it is certainly possible to have leaks at other locations and with other products.

The band should be tested before it is placed into a patient so there should not be a leak as the device is placed into the abdomen. However there are several ways the device can be injured.

1). If the insertion of the device through the abdominal wall is difficult or if the insertion through the trocar that helps with the passage of the band into the abdomen is difficult, the balloon could be torn. Although a tear could be seen by the surgeon and/or assistant it is possible that it is not able to be seen.

2). The balloon could be torn or punctured also by an instrument or a needle as the band is placed around the upper stomach or by the needle as it is sutured into place. Unless it was noted at the time of the puncture it would be very difficult to see this problem.

3). The tubing is unlikely to be injured during placement of the adjustable gastric band but it certainly could be punctured by the needle used during an adjustment. This could occur as the surgeon is trying to access the port. If the needle punctured the tubing instead of the port the water that is placed into the port could leak out of the tubing puncture site, especially when additional fluid causes increasing pressure in the system which occurred in the original higher pressure Lap-Band. Also the connection in the Lap-Band port has an unprotected connection as the tubing leaves the port making it a fairly easy location to injure the tubing. In the Realize Band system the location where the port is connected to the tubing is protected from puncture by metal or hard plastic for about 1/2 inch. It is therefore less likely that the tubing will be punctured close to the port in the Realize Band system.

4). One other possible leak from a Lap-Band system is at the steel connector site where the tubing that leads to the band is connected to the tubing that leads to the port. This can occur as the steel connector is inserted into the tubing or it could occur several months or years later as the tubing becomes more brittle with age. This connector is not part of the Realize Band system and the tubing does not seem to become more brittle with time with the Realize Band material used for the tubing.

To repair a leak in the tubing or near the port the port and or a porting of the tubing will need to be removed and replaced. This is a relatively easy operation and does not require replacement of the band that was placed around the upper part of the stomach. However if the gastric band itself is leak in the band must be replaced.

Therefore, if you are not feeling the restriction you expect even after a few adjustments you should return to your surgeon and ask if a leak is a possible problem.