Port Incision Won’t Close After Lap Band Surgery

Question Below Submitted By:  

Anonymous (a patient from Houston, TX)

On July 12th I went in for lap band surgery. My weight on surgery day was 292 pounds. The doctor made 5 entry points on my stomach (the port is on right side). The doctor used staples to close entry spots,and after 2 1/2 weeks the staples taken out.

Every entry closed up except the one where the port is. The cut is still open but is not red. There is puss leaking out into the gauze pad at a rate of about 2 tablespoons 2 times per day, sometimes 3 or 4 depending how active I am that day.

My medical history is as follows: m.S,,bi-poller, adhd, plates in r-hip, l-wrist, l-ankle, screws r-knee due to car accident on 2/9/09. Also had gallbladder removed years ago.

All of my medical problems are controlled with medication:

    • Kolapin
    • Zanax
    • Kadian
    • Addarall
    • Zanaflex
    • Lotrel
    • Batasuron
    • Zoloft

I have seen my PCP about this, and he prescribed an antibiotic for the hole in stomach which did not help!

My lap-band doctor is 2 hours away from my home in Houston, TX.

If you have any ideas why this is happening to me please share your thoughts!

Thank you,

Kellie

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01.

Expert Responses to the Question Above

Drainage from Lap-Band Port Wound

by: Dr. Marc Bessler, Center for Metabolic & Weight Loss Surgery at New York Presbyterian Hospital/Columbia University Medical Center

Dear Kellie,

Sorry to hear about your port problem. Almost certainly you have a port infection.

There are generally 2 causes for this.

One is a wound infection from the surgery itself. The treatment for this would be to open the wound and use antibiotics. If that does not heal the port would have to be removed and replaced at a different location after the wound heals.

The other cause is a band erosion in which case the infection actually starts at the band and travels to the port. This generally does not happen so early after surgery unless there was some injury to the stomach at the time of surgery. If erosion is the cause then the band and port need to be removed.

I strongly encourage you to see a surgeon and ideally the surgeon who put in the band. This problem will not likely go away unit at least the port is removed. If the infection lasts too long it may actually lead to an erosion of the band and then need band removal.

Unfortunately, although the band is a bit safer operation than say a sleeve gastrectomy and the complications tend to be less severe, band has the highest rate of problems and need for re-operation in up to 1/3 of patients. Please go see your surgeon.

Good luck,
Marc Bessler, M.D.

long island bariatric surgeon

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DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

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02.

Patient Responses to the Question Above

Please seek medical help

by: Beth

I'm wondering if mine is one of those rare cases -- the way I read your post, your port is underneath an incision...? Mine was "pushed" into its position away from any scar, so my largest incision/scar must be the one they inserted my port through.

Mine all healed relatively quickly and he used stitches instead of staples.But if you're now two months out and you're still experiencing pus, that could mean there's an infection or the potential for one if the incision isn't red, painful, or inflamed.

From an online source: "When seen in a wound or dry skin, pus indicates the area is infected and should be cleaned with antiseptic."I'm sure you're cleaning it, but I'm concerned about the part where it mentions infection.I would say you either need to return to your PCP and see what s/he thinks, because the antibiotic SHOULD have cleared it up.

I'm concerned that it didn't.

You may need to bite the bullet and take that two-hour trip to your band doctor's office.

No matter what you do, you do NOT want to sit on this.

Your incision is not a surface scratch -- you run the risk that there is a lot more going on under the skin than you know, and that can cause you a LOT of issues if not dealt with immediately.

Leakage from port wound

by: Lonicera The Bandit

Wow that's heavy leakage - they need to sort you out. Mine remained open for a couple of weeks, which worried me, but I was told it was OK as long as I kept an eye on it. It then closed and I was fine. You don't want to risk infection - you must go back to the place where the operation was performed, as that's their responsibility. Let us know how you're getting on. Lonicera The Bandit

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