The port is the small reservoir under your skin that the band's fluid is added through, joined to the band by tubing. Common problems are a port that has flipped or moved so it cannot be reached with a needle, a slow leak that makes the band lose its restriction, pain at the site, and infection. Most are not dangerous, but leaks and flips usually need a procedure to fix.
How the port and tubing work
According to the FDA's Summary of Safety and Effectiveness Data, the access port is placed "in or on the rectus muscle," the long muscle down the front of the abdomen. It connects to the band through about 50 cm of kink-resistant silicone tubing. The port has a self-sealing membrane (septum) that is entered with a special non-coring needle. The FDA labeling warns that ordinary hypodermic needles may damage it and cause leaks, and that tilting the needle once it is in can do the same.
The FDA labeling also warns that people have tried to adjust superficially placed ports themselves, which "can result in inappropriate band tightness, infection and other complications." Only a trained clinician should adjust the band.
Common port and tubing problems
Flipped or moved port
A port can turn over or shift, so the needle cannot reach the septum. You may first learn about it when a fill cannot be done. In the original U.S. trial summarised by the FDA, port displacement was reported in 6% of 299 people. Nine ports had to be repositioned or re-stitched because they could not be accessed. The Canadian Journal of Surgery review by Eid and colleagues gives a range of 2.5% to 6% for port displacement.
Leaks in the port or tubing
The Eid review describes port breakage as usually showing up as "a slow leak with the loss of the injected fluid volume" when fluid is drawn back out. You may notice your restriction fading days or weeks after each fill. In the FDA trial, 3% of people had port leakage from cracked tubing or a loose connection between the tubing and port, and all were resolved by replacing the port or tubing. Leaks from the band itself were rarer (0.7%).
Port-site pain
Some tenderness for a day or two after a fill is common. The FDA trial recorded port-site pain in 9% of people, mostly mild. Pain that keeps coming back with movement can mean the port has shifted; in the trial, three ports were re-secured for this reason.
Port infection
An American Family Physician review (Kodner and Hartman, 2014) explains that port infection usually happens soon after surgery, but can occur later. Signs are redness, warmth, tenderness and fever. A series of 228 band patients from China (Wang and colleagues, 2013) found early port-site infections in 2.2%, all healed with dressings and antibiotics. A late infection is different. The Eid review notes that late port infections are often caused by band erosion, with infection tracking up the tubing, so the band itself is checked too. See Lap-Band erosion.
Disconnected tubing and a prominent port
The tubing can separate from the port. In a 2019 study of CT scans in band patients (Kerpel and colleagues), 2.5% showed a disconnected tube. After a lot of weight loss, the port can also become easy to see or feel. Kodner and Hartman describe replacing it with a lower-profile port if the skin over it becomes red, tender or thin.
How port problems are found and fixed
The Eid review describes the usual test: dilute contrast dye is injected into the port under fluoroscopy (a live X-ray), which shows whether fluid escapes and where. Kodner and Hartman also recommend checking port integrity and imaging the upper GI tract as the first steps for anyone with pain, vomiting or trouble swallowing. Our tests for Lap-Band problems page explains these studies.
Fixes depend on the problem. According to the Eid review, port, tubing or band replacement is usually needed, depending on where the leak is. In the FDA trial, port and tubing leaks were resolved by replacing those parts without replacing the band, and ports removed because of infection were put back later, once the infection had cleared.
When to call
Go to an emergency room or call 911 if
- You have fever and chills with redness spreading from the port site
- You have severe abdominal pain, or you cannot keep liquids down
Call the office if
- The skin over the port is red, warm, swollen or draining, and you have no fever
- Your restriction fades within days or weeks of each fill
- You have sharp pain at the port that does not settle
- You were told a fill could not be done because the port could not be reached
Frequently asked questions
Can a leaking port be replaced without removing my band?
Often, yes. In the FDA trial, leaks at or near the port connection were fixed by replacing the port or tubing, without replacing the band. A leak in the band itself is different and needs band replacement or removal. A contrast study of the port and tubing shows where the leak is before anything is planned.
Is it normal to feel or see my port after losing weight?
Yes, it often becomes easier to feel as the fat layer over it gets thinner. By itself that is not a problem. If the skin over the port turns red, thin, tender or starts to break down, call the office, because the port may need to be moved or swapped for a lower-profile one.
Why did a fill not work when my port is under the skin?
The needle may have missed a port that has turned or shifted, or fluid may be leaking out through a crack. Clinicians sometimes use an X-ray screen to guide the needle; the FDA labeling describes this technique. If a port cannot be reached, it may need to be re-stitched in a short procedure.
Can I exercise hard or do sit-ups with a port?
Ask your surgeon when you are cleared and what suits you. The FDA labeling says the port should be placed away from areas affected by heavy physical activity, because movement there can make it hard to reach. If one movement keeps causing a pulling pain at the port, mention it at your next visit.
Talk with Dr. Davtyan in Rancho Cucamonga
Dr. David G. Davtyan, MD, FACS, FICS, FASMBS, is a bariatric surgeon who has a Lap-Band himself. If your port is giving you trouble, call the Rancho Cucamonga office at 8330 Red Oak Street, Suite 201, Rancho Cucamonga, CA 91730, on 909-355-2525 or toll free 877-9-BE-SLIM (877-923-7546), or use the contact page. The first consultation is complimentary and Hablamos Español. For fills and routine care, see Lap-Band adjustments and tightness and the Rancho Cucamonga Lap-Band guide.
Sources
More in the Lap-Band in Rancho Cucamonga guide
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