A Serious but Rare Complication of Laparoscopic Adjustable Gastric Banding: Bowel Obstruction Due to Caecal Volvulus
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Laparoscopic adjustable gastric banding (LAGB) is a widely performed surgical procedure for the treatment of morbid obesity. LAGB complications have declined since its development in the early 1990s. However, LAGB complications are still occurring and can sometimes be serious and life threatening. These complications are related either to the band or to the access port, such as band slippage or tubing disconnection, retrospectively. We report a rare case of bowel obstruction due to caecal volvulus caused by connecting tube used in LAP-BAND system in a bariatric operation, which obstructed a caecal loop, in a female who had undergone LAGB 2 years previously. Diagnosis of bowel obstruction was established with plain abdominal radiograph appearances. Follow-up abdominal computed tomography findings confirmed the diagnosis of caecal obstruction and revealed the underlying cause for this obstruction. Surgery was performed, and intraoperative examination demonstrated that connecting tube of the LAP-BAND system was a main causative factor. We can hypothesize that bowel obstruction secondary to LAGB operation may become frequently diagnosed as more LAGB operations performed worldwide. The emergence of many problems, such as this, can be minimized with enhancement in the development of better surgical materials, proper operative technique, and close postoperative management and follow-up.
KeywordsBariatric surgery Gastroplasty Intestinal obstruction Intestinal volvulus Morbid obesity Postoperative complications
We would like to express our sincere gratitude to Dr. Nicholas Brett from the Medical Imaging Department and Dr. Milan Djeric from General Surgical Unit of Royal Hobart Hospital for their assistance and support. We also would like to thank the Medical Imaging Department of Royal Hobart Hospital of Tasmania for their editorial assistance in the preparation of this article.
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