Marlex mesh erosion: a complication of horizontal banded gastroplasty

One-hundred and thirty-eight obese patients underwent horizontal banded gastroplasty. The stoma in each case was reinforced with Marlex mesh. Fifty of these patients developed upper gastrointestinal symptoms sufficiently severe to require endoscopy. At endoscopy 12 were found to have erosion of the Marlex mesh into the stoma. Mesh erosion was found at various intervals postoperatively ranging from 5 weeks to 55 months with a mean of 23 months. Nine of the 12 had associated stenosis of the stoma and three had dehiscence of the staple line. There were no symptoms peculiar to Marlex erosion. Seven patients required surgical revision of the stoma, four were treated medically, and one was treated with a combination of stomal dilation and medical therapy.