Surgical revision after failure of laparoscopic adjustable gastric banding

Abstract

AGB placement is associated with a variety of complications. In most cases surgical complications can be treated with minimally invasive surgery, which should allow further weight loss and improvement of quality of life during long-term follow-up. Alternative bariatric procedures should be reserved for patients with poor outcome after surgical revision of the AGB.

Reoperations after gastric banding: replacement or alternative procedures?

“…After a follow-up period of 42 months, patients' BMI decreased from 37.8 to 29.5 kg/ m 2 . Similar to the presented study, BMI of patients whose band was removed without any further substitution increased from 32.6 to 37.4 kg/m 2 [33]. Gagner et al reviewed a study of four cohorts with a total of 193 patients that underwent band replacement after their first gastric banding [34].…”

Esophageal dilation after laparoscopic adjustable gastric banding: a more systematic approach is needed

“…Esophageal dilation found in barium studies reported in literature show an incidence ranging from 0.5% to 77.9% [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] (Table 4). A few reports mention esophageal dilation as one of the reasons for reoperating after LASGB (1.8-4.1% of the reoperations) [10,13,14].…”

“…A few reports mention esophageal dilation as one of the reasons for reoperating after LASGB (1.8-4.1% of the reoperations) [10,13,14]. However, it is unclear in most reports whether all the patients had barium follow-up studies and how esophageal dilation was defined.…”

Obesity surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery (EAES)

“…If the pars flaccida technique was not used in the primary operation, therapy consists of laparoscopic revision (EL 4 [59]). Other alternatives are band repositioning, rebanding, or conversion to other procedures (EL 4 [349]). …”

“…Access ports can twist or become infected. While port rotation can be corrected by revisional surgical fixation (EL 4 [170,225,349]), infection requires port removal. First, the tube is placed in the abdominal cavity.…”