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22 Laparoscopic Adjustable Gastric Banding: Management of Complications

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Minimally Invasive Bariatric Surgery

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Abstract

Early adverse events occur after LAGB as may occur after any major abdominal procedure, but these have been surprisingly uncommon and are manageable. Access port site infection is preventable. Trauma to the stomach or other regional structures can be avoided by detailed knowledge of the anatomy and gentle technique. Perioperative mortality should approach zero.

Symmetrical enlargements and other forms of proximal gastric enlargements such as slips remain the major late adverse event. They can be markedly reduced by band selection and by proper patient education regarding eating small amounts of good food slowly. Understanding the physiology of the band, particularly the mechanisms for induction of satiety and satiation, is essential for optimal patient education. Erosions remain an uncommon issue. All late adverse events are manageable and, with correction, the patient’s weight loss pattern can be predicted to follow the weight loss of the overall group.

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Author information

Authors and Affiliations

  1. Centre for Obesity Research and Education (CORE), Monash Medical School, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia

    Paul O’Brien M.D.

Authors
  1. Paul O’Brien M.D.
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Corresponding author

Correspondence to Paul O’Brien M.D. .

Editor information

Editors and Affiliations

  1. Cleveland Clinic Lerner College of Medicine, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA

    Stacy A. Brethauer

  2. Cleveland Clinic Lerner College of Medicine, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA

    Philip R. Schauer

  3. Department of Surgery, Health Sciences Center, University of Virginia Health System, Charlottesville, Virginia, USA

    Bruce D. Schirmer

Review Questions and Answers

Review Questions and Answers

  1. 1.

    An optimal tightness of the adjustable band occurs when:

    1. (a)

      Solid food sits above the band to give a sense of fullness

    2. (b)

      Liquids can pass with some resistance across the band

    3. (c)

      There is little appetite for food throughout the day

    4. (d)

      Barium imaging shows slow transit

    5. (e)

      A small amount of food satisfies any hunger

      (c) and (e) are correct

  2. 2.

    The following are true regarding proximal gastric enlargements above the band:

    1. (a)

      All enlargements are associated with slippage of the stomach from below

    2. (b)

      Anterior prolapse can develop into an acute surgical emergency

    3. (c)

      Posterior prolapse is largely prevented by use of the pars flaccida pathway

    4. (d)

      Symmetrical enlargement of the stomach can be distinguished from a symmetrical enlargement of the esophagus by barium swallow

    5. e.

      Most symmetrical enlargements will resolve by removing fluid from the band

      (b), (c) and (e) are correct

  3. 3.

    Erosion of the gastric band into the lumen of the stomach:

    1. (a)

      Is likely to occur in about 1 % of patients

    2. (b)

      Is due to adjusting the band too tightly

    3. (c)

      Is the commonest cause of an acute abdomen in someone with a gastric band

    4. (d)

      Can be effectively treated by removal of the band and later replacement

    5. (e)

      Removal of the band by endoscopic technique is simpler and safer than laparoscopic approach

      (a) and (d) are correct

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O’Brien, P. (2015). 22 Laparoscopic Adjustable Gastric Banding: Management of Complications. In: Brethauer, S., Schauer, P., Schirmer, B. (eds) Minimally Invasive Bariatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1637-5_22

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  • DOI: https://doi.org/10.1007/978-1-4939-1637-5_22

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1636-8

  • Online ISBN: 978-1-4939-1637-5

  • eBook Packages: MedicineMedicine (R0)

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