There are few main concerns with the AGB process that I know about.

Death

Erosion

Slippage.

Band Migration

Death:  There have been about 80,000 procedures world wide since the introduction of the band in 1985.  As far as I know, there has not been a single death due to the band device itself.  The only death that I know about was an uncontrolled bleeding during a surgery, and was not related to the band at all.

Disclaimer: This is just one person's opinion.  I could be wrong.

Slippage: When the band repositions itself lower on the stomach.  This generally causes the effective 'pouch' to be huge.  Because the stomach will fold over (Like a tipped uterus), the stoma is effectively blocked.  Any solids eaten during this time will cause massive vomiting, as the stoma is blocked by the folded over stomach.  The patient is reduced to liquids only until repaired surgically.

Cause: Is not fully understood at this time.  I personally, have chatted with 4 Doctors about the causes.  All propose that every time we PB, throw up, or vomit, that there is a tendency for some of the skin of the stomach to be 'fluttered' up through the stoma.  In time, some parts of wall of the stomach will be drawn up though the stoma and the net result is that the lower stomach starts to creep up through the stoma to effectively enlarge the pouch.

Solution: The solution is of multiple possibilities.

1. Drain the band - See if it repositions itself

2. Surgically, try to pull the stomach back into place.

3. Surgically, Remove and replace the band.

4. Surgically, Remove the band.

Future:  Slippage used to be quite common in the past.  Some medical papers suggest that it may have occurred in 15-20% of all patients during the early years of all the AGB surgeries.  The Doctors may have a solution, in that they all stitch the band into position.   Slippage rates during the past few years has fallen to about 1% of all band patients.  Not to bad since the death rate due to surgery of RNY is higher than this.

Disclaimer: This is just one person's opinion.  I could be wrong.

Band Migration(aka Erosion): Is when the band cuts through the stomach wall.  Could go through into the stomach itself.

Generally Thought to be caused by an overfill. Or a fill to tight for the person.

When the band is filled to a pressure of higher than the blood pressure, the blood flow to the stomach tissues just under the band stops. The stomach tissue just under the band can not get oxygen. The tissue dies and the band moves into that space. Sooner or later, the band will 'erode' into the stomach. Must get immediate stomach surgery. I have not heard of this as a problem for about 2-3 years. My experience, is that this phenomena has virtually disappeared after more conservative fill procedures were adopted (circa 1998 ).  But don't you know that I just heard about 3 cases (Aug 2002).

There was a problem with the SAGB. When filled partially. The balloon folds itself into a triangle with sharp and well defined pinched areas in three locations. Any stomach tissue in those pinched areas would die from lack of oxygen. At last year's bash, there was a representative from OBtech with a sample of their present band. The band that I saw, there at the bash exhibited the same folding and pinching when filled (In one case, only) with as little as 6.0 cc. although the manufacturer suggests a maximum fill of 9.0 cc?

The same triangle and pinch problem does occur on the LapBand device. In the one that I played with, you had to insert more than 18.0 cc of saline to see the folding and pinching problem. But, a fill of 18.0 cc is way over the maximum of 4.5cc recommended by the manufacturer.

Another problem about Band Migration is the sharp edges of the SAGB device.  One glance at this dragons toothed raw edge of this band, It is easy to see how the sharp edges could cut into the adjacent stomach wall and migrate into the stomach.

Disclaimer: This is just one person's opinion.  I could be wrong.

Esophageal Erosion:  Is when the acid from reflux eats away the lining of your
esophagus.

I have NEVER heard of that ever happening with a band in place.  The amount of stomach acid in the pouch is none to minimum.  Therefore, the amount of stomach acid in a typical reflux session is (IMHO) not enough to cause this problem.  Although I suppose anything is possible.

Disclaimer: This is just one person's opinion.  I could be wrong.