Laparoscopic repair of access port site hernia after Lap-Band® system implantation

Background: The appearance of hernia around the access port site after implantation of a laparoscopic adjustable gastric band “LAGB” is a complication that can limit the beneficial effect of the device. We evaluated the incidence of hernias at the port-site for band adjustment and propose a technique for its repair. Methods: A retrospective study was conducted of 459 patients who underwent LAGB system implantation for treatment of morbid obesity between January 1999 and July 2001. We recorded all complications that occurred following LAGB placement, with special emphasis on port site hernia. Results: 3 out of the 459 patients “0.65%” had a hernia at the site where the reservoir had been implanted. The use of a trocar >11 mm should be avoided to prevent this complication. We describe our technique of repair of the hernia by intraperitoneal detachment and pulling of the access reservoir into the peritoneal cavity, intraperitoneal repair of the defect with Gore-Tex® Dual mesh, and reimplantation of the reservoir. Conclusions: Our technique successfully repaired the hernia, and enabled continuation of adjustments to the gastric band.