Laparoscopic Band Removal Research Articles

Laparoscopic Band Removal with Transgastric Gastrogastric Fistula Creation for Gastric Outlet Obstruction After Vertical Banded Gastroplasty.

Laparoscopic Band Removal with Transgastric Gastrogastric Fistula Creation for Gastric Outlet Obstruction After Vertical Banded Gastroplasty.

One Stage Laparoscopic Band Removal and Sleeve Gastrectomy after Failure of Gastric Banding in Morbidly Obese Patients

Background: Obesity is one of the public health problems nowadays which is associated with a variety of diseases including the whole systems, specially the cardiovascular system. Bariatric surgeries believed to be the most effective long-term management for morbid obesity that decrease both morbidity and mortality. One of these surgeries is laparoscopic adjustable gastric banding. Objective: To study the safety and effectiveness of single stage revision of failed gastric banding to sleeve gastrectomy only in uncomplicated cases who had failure of weight loss or regain weight after a period from having gastric banding. Patients and methods: The present study is a retrograde observational study including 150 morbidly obese patients who previously had laparoscopic adjustable gastric banding and failed to lose adequate weight or regained weight. Patients were recruited and treated at Ain Shams university hospitals from December 2015 to December 2017. All patients had laparoscopic band removal and sleeve gastrectomy in the same procedure. All patients received information about surgical technique, risks of the operation and other options for treatment. Results: The mean age of the cohort was 36± 10 years (range 20-60). Before band insertion the mean BMI of the cohort was 43.4 ± 5.2 (range 31.6-55.8). The mean interval between primary and revision surgery was 5.5±1 year (range 2.8-9.6). The mean BMI of the study prior to revisional laparoscopic band removal and sleeve gastrectomy was 42 ± 5.5 (range 35-50). The excess body weight loss percentage (EBWL%) in the first 3 months was 32% and 65% after 6 months. Conclusion: Laparoscopic gastric band removal with conversion to sleeve gastrectomy in one operation is applicable for patients with failure of weight loss or regaining weight after adjustable gastric band. It can be done with low incidence of complications, and yet a weight loss results that is similar to primary sleeve gastrectomy.

Intraluminal migrated adjustable gastric band after banded bypass into the terminal ileum: a case report of laparoscopic band removal

Intraluminal migrated adjustable gastric band after banded bypass into the terminal ileum: a case report of laparoscopic band removal

Sleeve gastrectomy for gastric band failures – A prospective study

BackgroundWe prospectively evaluated the feasibility and efficacy of a strategy of performing concomitant laparoscopic band removal and sleeve gastrectomy on all-comers who had a failed laparoscopic adjustable gastric band (LABG) and analysed the impact of the reason for revision surgery on outcomes. MethodsOver a two-year period, 23 patients who previously had LAGB insertion were referred for revision surgery. Of this cohort, three patients elected to undergo band removal alone. Of the remaining 20 patients, 10 presented with weight regain and 10 presented with pathological symptoms secondary to band migration (band complication group). All patients were listed for simultaneous LABG removal and sleeve gastrectomy and the outcomes of the two groups analysed. ResultsSimultaneous band removal and sleeve gastrectomy was achieved in all cases of weight regain and in 7 cases of band complications. There were no complications in the weight regain group and three major morbidities in the band complication group. At the time of revision, the mean body mass index was 40.3 ± 1.5; however at a mean follow-up period of 2.2 ± 0.28 years the mean BMI of the cohort had fallen to 35.9 ± 1.4. The mean BMI was significantly lower in the band complication group (p = 0.03). ConclusionsGastric band removal and revision sleeve gastrectomy following failed LABG is feasible as a single-stage procedure with good outcomes. The optimum peri-operative results of this approach are seen in patients with weight regain whilst the longer term outcomes are superior in those with band complications.

Endoscopic Repair of Gastrocutaneous Fistula: 2010 Presidential Poster

Purpose: Laparoscopic adjustable gastric banding (LAGB) is one of the most frequently performed surgical procedures for the treatment of obesity in Australia, Europe, and the USA. It is considered to be the least invasive of bariatric procedures. Complications such as esophagitis, infection, gastric necrosis, band migration, and gastric fistulas have been reported. We report a case of gastrocutaneous fistula caused by laparoscopic band removal, which was successfully closed using endoclips and bioglue. A 58 year old woman with a history of LAGB performed 20 years previously presented with a foul discharge from the epigastric region two days after removal of her gastric lap band. Endoscopy identified a gastrocutaneous fistula initiating within the gastric antrum and four endoscopic clips were deployed to approximate the edges of the fistula (Figure 1). The epigastric discharge decreased transiently only to increase again. Interventional Radiology subsequently injected bioglue into the fistulous tract which did not resolve the drainage. A combined procedure with injection of bioglue and simultaneous endoclip placement was performed. Drainage ceased within 3 days and the patient has remained well. Bariatric surgery is increasingly utilized as a treatment for obesity. Complication rates over 10 years in two large studies were 20 to 50%; with serious complication rates of only 1.2%. Serious complication rates decline as experience increases, but cumulative long term complication rates increase as the length of follow up increases. Endoscopic clipping appears to be a safe technique for closure of gastrocutaneous fistulae. Our case is the first described of gastrocutaneous fistula closure utilizing bioglue and clipping after laparoscopic band removal.Figure 1: Left side: Gastrocutaneous fistula from endoscopy views. Top right: Endoclips approximating the gastrocutaneous fistula.

PL-123: Treatment of megaesophagus after adjustable gastric banding for morbid obesity BY band removal and simultaneous Roux-en-Y gastric bypass

Laparoscopic adjustable gastric banding (LAGB) can impair esophageal peristalsis and can also cause a lack of relaxation of the lower esophageal sphincter, leading to esophageal dilation. The aim of the present study was to determine the improvement and/or elimination of megaesophagus after gastric banding by laparoscopic band removal and simultaneously Roux-en-Y gastric bypass (LRYGB).

Simultaneous Gastric and Colic Laparoscopic Adjustable Gastric Band Migration. Complication of Bariatric Surgery

Laparoscopic adjustable gastric banding (LAGB) is a minimally invasive treatment for morbid obesity, which has proved its safety, efficiency, and reversibility. Postoperative complications are rare and might be related with the reservoir, connecting tube, or with the band itself. The lack or unspecificity of clinical signs and symptoms makes the diagnosis of gastric band erosion difficult. The authors present the case of a 54-year-old female, submitted to laparoscopic adjustable gastric banding in April 2004 (BMI = 40 kg/m(2)). During the first year, she reduced her body mass index to 30 and remained stable thereafter. In August 2008, while investigating a moderate colicky abdominal pain, she was submitted to a colonoscopy that showed part of the band inside the transverse colon. Two exams were performed: the abdominal CT scan, which showed the connecting tube inside the transverse colon lumen and the lap band which was apparently well positioned around the stomach, and an upper digestive endoscopy that revealed band migration to the stomach lumen. The patient underwent laparoscopic band removal and closure of both stomach and colon walls, thus treating the fistula. LAGB erosion and migration is a late complication of this surgery that frequently needs surgical removal. LAGB migration to colon or stomach is described in literature isolated. Simultaneous erosion to stomach and colon lumen, with a gastrocolic fistula formation, has never been described before, making this case a unique one.

Treatment of chronic obstruction as late complication of adjustable gastric band

Laparoscopic adjustable gastric banding is growing in popularity in the United States. A rare late complication is obstruction at the level of the band, with concentric gastric pouch dilation. In our patient, endoscopy showed gastric pouch dilation with food impaction and a restricted outlet. We describe the combined endoscopic and laparoscopic approach for alleviation of chronic obstruction as a late complication of an adjustable gastric band. This combined approach included laparoscopic band removal and scar excision with intraoperative endoscopic dilation.

Treatment of Intra-Gastric Band Migration Following Laparoscopic Banding: Safety and Feasibility of Simultaneous Laparoscopic Band Removal and Replacement

Intra-gastric band migration (band erosion) following laparoscopic adjustable gastric banding (LAGB) is a known complication requiring revisional surgery. Management has most often involved band removal and suturing of the stomach wall, followed by delayed replacement at a third operation. We report our experience with simultaneous band removal and replacement. Between May 2001 and December 2003, we performed 754 laparoscopic operations using the Lap-Band (R). Patients developing band erosion were treated by laparoscopic band removal and immediate replacement of a new band following gastric wall repair. 16 patients (2.1%) developed band erosion after a mean of 23 months following surgery (range 11-40 months). Patients presented with epigastric pain (6), port-site bulge (3) or were asymptomatic (7), band erosion being suspected during fluoroscopy for band adjustment and confirmed by gastroscopy. Postoperatively, 11 patients developed fever that responded to antibiotics. No patient suffered from intra-abdominal infection, wound infection, pneumonia or pulmonary embolism. Mean hospital stay was 4 days (range 1-8 days). Band erosion following LAGB can be treated safely with simultaneous laparoscopic band removal, gastric wall suturing and immediate replacement of the band, thereby preventing weight gain, the appearance of co-morbidities and the need for additional surgery.

Laparoscopic Removal of Gastric Band after Open Banded Gastric Bypass

Open banded gastric bypass has been the choice of some bariatric surgeons. This procedure includes a band (of various materials) around the gastric pouch. While there are advantages to this band, erosion and/or displacement of the band may occur. We describe a case of a symptomatic displaced band which was treated by laparoscopic removal. Laparoscopic removal of the band after open banded gastric bypass is feasible. Revision of previous bariatric surgery may be performed laparoscopically if the technical expertise is available.

Lap-Band erosion: incidence and treatment.

Laparoscopic adjustable gastric banding (LAGB) is an effective and safe surgical treatment for morbid obesity. Migration of the band through the stomach wall is a well-known late complication that may jeopardize the aim of the treatment--permanent weight reduction. 301 patients were followed for > or = 2 years (mean 39 months) after a Lap-Band procedure. Cases of erosion were studied retrospectively. 5 patients (1.66%) developed erosions. Laparoscopic band removal was carried out in these 5 cases without complication. The first 4 have received a new Lap-Band, and all are doing well. Band erosion is a bothersome late complication after LAGB and requires band removal. Rebanding is a feasible option. Further study and longer follow-up are necessary to determine whether these patients will develop erosion again.

Laparoscopic Management of Lap-Band® Erosion

Laparoscopic adjustable silicone gastric banding (LASGB) is the bariatric operation of choice in our institution for most morbidly obese patients. The advantage of LASGB is a minimally invasive procedure, with low systemic and operative complication rates. However this procedure is not free from significant postoperative problems that may arise at a later stage. 950 patients underwent LASGB between November 1996 and May 2000, with a median follow-up of 21 months. 3 patients (0.31%), developed band erosion 6 to 8 months following the original procedure. Laparoscopic band removal was attempted in all 3 patients. The charts of all patients were reviewed for the postoperative course of the original operation as well as the removal of the band. 2 patients presented with abscess formation at the port site, and 1 patient suffered from a gastric fistula at the port site 6 months following surgery. In all patients the immediate postoperative course was not smooth; 2 patients developed a subphrenic collection drained percutaneously, and one patient had fever, treated empirically with intravenous antibiotics. In all 3 patients, no leak was demonstrated by CT and barium meal. The diagnosis of band erosion was confirmed by gastroscopy, which demonstrated part of the band eroding through the gastric wall. All patients were operated laparoscopically. The band was removed and the gastric wall was sutured. The postoperative course was uneventful and patients left the hospital within 3 days. LapBand erosion following LASGB is very rare and may occur months following the operation. The postoperative course suggests that the erosion is the consequence of a minute stomach wall injury during the primary operation. Diagnosis is essential and the treatment of choice is laparoscopic band removal with suturing of the stomach wall. It is possible that a minute injury to the gastric wall during the initial procedure is the underlying cause of this complication.