Port complications may lead to Erosion

[Penni60 45]

I believe my Erosion was a end result of my port complications that started 2 months post band placement.

I had my band placed in April, by June my port area was reddened, hot, inflammed, itching, tender to touch. The Mexico surgeon that placed my band finally took a phone call from me after 3 weeks of trying to get in touch with him. He claimed that I was rejecting the band. WRONG!! I didn't know it at the time but a raging infection was brewing. We set up a time for me to go see him. About a week before I am to go see him I get this protruding thingy in the port area. IT was not through my skin but almost. I knew it was the tubing. You could feel the tubing through my skin. So I go visit my MX surgeon in TJ at his nifty swifty new offices. He tells me that I do not have an infection and that I do not need surgery. He also says to me that once I lose more weight the tubing will go back into place. Whatever that meant. SIGH!!

I don't agree with his assessment so I ask for a list of doctors that will take his patients in an emergency. Dr. Helmuth Billy was on that list. I called up his office and made an appt. He took one look at my protruding thingy and said you need to have the port repositioned and the tubing trimmed. The MX surgeon had not trimmed the excess tubing when the band was initially placed. If Dr. Billy had not repositioned and trimmed the tubing and fixed that then I would have had the same situation that Lisa experienced. THank goodness I didn't listen to the MX surgeon.

So fast forward to the 6th of Dec when I had my endosocopy and found Erosion. Dr. Billy seems to think the problems all started with my initial redness around the port site. So now that I no longer have the band I am advocating that anyone that has any port complications PUHLEASE seek out your BAND SURGEON and discuss your options.

Pictures to follow of all mentioned above.

[Penni60 45]

Redness around site that doc called rejection which was really infection.

[Penni60 45]

Here is the port protrusion thingy that happened two weeks after the redness appeared. This is when the MX doc told me to just lose more weight and it would reposition itself. SIGH!!

[Penni60 45]

Bumping for more input

[the best me 6]

Interesting. Thank God for Dr Billy...just how many times have you said that anyway?! Thanks for the pics, they are sure to help others.

No port problems has been my sanity these days. The erosions have me quite nervous and a bit edgy. I e-mailed my patient rep today with endo questions. I'll let you know what she says, but the fact that my port has been beautiful from the get-go is a real relief to me.

I can't believe Lopez said to just lose weight and that would go away. Huh? Geez.

[Anwyn 0]

Hi Penni,

I was talking to my surgeon last week about erosion and he completely agrees with you. He thinks port infections often lead to erosion because the bacteria travels up the tubing to the band.

It would certainly be interesting to know how many erosion cases were preceded by port infections.

[Penni60 45]

Anwyn if Inamed really wanted to help and provide some information then they could certainly follow all the infections and see just how many lead to Erosion. But they claim they can't and don't have the resources for that kind of study. I offered my services for FREE to help collect the data and 'cipher' it for them. THey still refused. SIGH!!!

[DrPleatman 3]

Penni:

Actually it's generally the other way around... band erosion leads to infection at the port site. The bacteria migrate from the stomach along the catheter out to the port. I've never heard of port infection causing a band erosion.

Band erosions present themselves in 2 ways:

1. no symptoms at all except for loss of restriction, and weight gain.

2. Port site infection

Mark Pleatman MD

www.laparoscopy.com/pleatman

248-334-5444

[psbilling 0]

I agree with Dr. Pleatman. Erosion causes port site infection. If a patient develops a port site infection, then we must be concerned with an erosion. The port and band need to be removed. It can be done laparoscopically but it is difficult. Once it is removed, I would recommend waiting six months and give the patient the option of another lap band ( a Vanguard band) or gastric bypass.

Peter Billing, MD

Edmonds, WA

pssurgicalclinic.com

[Penni60 45]

Dr. Pleatman and Dr. Billing: I am thankful that you are here to offer your opinions and I do respect them.

I have to disagree with losing restriction as a symptom of erosion, although I do understand some people may experience this symptom. I NEVER lost restriction at all. In fact I was at a high restriction up to the day I had my band removed. And yes I had it removed laparoscopically with NO problems whatsoever. I am recuperating just fine. Dr. Billing I am assuming it is difficult for the surgeon to remove laparoscopically and not difficult in terms of recovery. Generally speaking.

I also have to disagree with the theory port infections are a sign of erosion instead of port infections may be a reason the band erodes. I do know that once the band erodes it can cause an infection and the band and port need to be removed. My case was a suspected infection about 2 months after banding which presented itself with redness, swelling, heat, and tenderness around the port site the size of a large grapefruit. So if your theories are accurate then I had eroded at 2 months post op. Is that possible?

Strange? YES!! Infection? Maybe!! Could it have been a cause of my Erosion?? Who knows? Could I have been eroded at 2 months post op? SCARY to think of!! If I was eroded at 2 months then how did I manage to lose 65 lbs in all that time?

I had surgery to repostion my port at 3 months post op and the surgeon did a swab of my area and nothing was growing. So what caused my erosion if not the initial port issues? I never lost restriction EVER!

Erosion has just not been thoroughly explored yet. I am not sure it can be either. I do know the information being deciminated to the bandster population is from one extreme to the other not only by our band surgeons but also by Inamed.

My understanding about the make-up of the band, tubing and port is that they are porous and can harbor micro-organisms, therefore making it hard to fight any form of infection. The only recourse is to remove the port with a suspected infection and to treat with antibiotics and to leave the wound open to heal from the inside out. Then in 6 months you can begin to discuss the possibility of a new port.

Same thing with the band if there is a suspected infection then the band should come out and antibiotic treatment should follow. Also, waiting 6 months for a re-banding.

I don't mean to be disrespectful but sometimes the ones actually experiencing the signs and symptoms can become more knowledgeable than the one providing the treatments. I learned this while I was a nurse. And so did lots of the doctors that I worked under.

[DeLarla 22]

Sorry, but I have to disagree that port complications "may" lead to erosion. I have a feeling they most definitely DO lead to eroson. I don't agree with port removals or revisions after what I've been through. If the port goes bad, take the whole band out and wait 6 months to start over. Just my opinion, but I've seen and heard about way too many erosions after port complications. Way too many. Then again, I'm a grouchy bear right now because I have a fever from my band removal surgery, so maybe I'm just being a bitch.

[melati 0]

I agree. Most ppl I know with port infections have had them right from the outset. Erosion could not possibly happen at this speed.

BTW where are all my posts?

[ddflinn 0]

<p>if port infection symptoms are redness and heat can they go away? i had these symptoms for 2 weeks on my port site scar. the day i went to my doctor they were gone. he prescribed 750mg Elquine 1 pill 7 days. he said i had trama to the area and Fluid built up.(gym equipment caused a bruise 3 weeks ago). i still have some itching in that area. should i seek a second opinion or i'm i freaked out by the other stories i've read.</p>

[La_madam 20]

Band erosions present themselves in 2 ways:

1. no symptoms at all except for loss of restriction, and weight gain.

2. Port site infection

Interesting, I had neither of the above mentioned and I had erosion. My restriction was better then it had ever been the last month prior to me finding out I was eroded. I had a 10lb loss in October 18 months post op. Found out my band was eroded in November. Dr. Ortiz thinks my erosion was caused from a stitch that he was concerned about back in April when he preformed surgery for my bowel obstruction he actually saved both my endo results from April & Nov and will present them at the conference he is attending in Feb.

[DeLarla 22]

Port infections lead to erosion, and "maybe" vice versa. My port was infected the same week of my original surgery. They removed the port and did and endoscopy, which revealed no erosion. Eight months later I had another endoscopy that came back clean, so they gave me a 2nd port. The 2nd port immediately became infected and had to be removed. At that time, I had an endoscopy, a stomach biopsy and a laproscopy. All test results were negative for erosion.

As far losing restriction being one of the symptoms of erosion, so far I don't know anybody that's eroded who will agree. I have 8 friends who have had their bands removed due to erosion (in the last year.) We all had decent restriction. I had a couple PBs last week because my restriction was still working like a charm. I even tried to enjoy a "Last Supper" of pizza before having my band removed, but I couldn't even finish one piece - and they were small slices.