There are several reasons why bands leak and sometimes it’s impossible to find the precise reason. The most common reasons are:
Device failure – Usually this is when the band leaks at the site of the access port. The manufacturer explains that leaks can occur and this risk is impossible to eradicate. That’s of no consolation to the patients who experience them but fortunately these types of leak are few in number.
Tubing separation – In some patients the tubing will fracture. It’s impossible to tell for sure why this happens and there are differing theories about it. The most common are that there could be a twist in the tubing that over time causes the tubing to perish. Another is that the tubing becomes kinked in the stomach simply due to the way the band sits in the abdominal cavity. It’s normally impossible to establish exactly why tubing fractures occur. The fracture will usually appear where the band tubing links to the access port (for a Bioring gastric band) or where the port tubing connects to the band tubing for an Apollo AP band. This connection of port and band is always the weakest point in the band system.
Tubing puncture – Occasionally a tubing leak arises from an attempted band adjustment. Sometimes ports sit deep below the surface of the skin and are hard to access. No matter how skilful the band fill nurse who adjusts your band there will be bands where the tubing is punctured instead of the access port. These types of leak are usually visible on x ray.
Port leak – This is the most common cause of leaks because it is the port where we inject saline in and out of the band. Some bands will be adjusted more than 10 times so there is the chance of damaging the port through normal ‘wear and tear’. Again, it’s impossible to know why these leaks occur in some bands and not in others. No amount of laboratory investigation can reliably link cause and effect. There are many theories about the causes of these leaks and three possible reasons are injecting in exactly the same place on two occasions (this is impossible to see), injecting into the outer edge of the septum (the soft centre of the port) or accessing the port at an angle. Regrettably, port leaks are just an unavoidable risk of gastric banding.
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