Symmetrical pouch dilatation after laparoscopic adjustable gastric banding: incidence and management.

Obesity Surgery
Wendy BrownPaul E O'Brien

Abstract

Laparoscopic adjustable gastric banding (LAGB) has commonly been complicated by the problem of band slippage or prolapse. Since popularization of the pars flaccida approach and improved anterior fixation, it is our impression that the problem of symmetrical dilatation of the proximal gastric pouch has become more important. We have reviewed the results of a series of 425 LAGB all performed by the pars flaccida approach from June 2003 to October 2007 to analyze the incidence and implications of this new pattern. There were no posterior prolapses, 2 anterior prolapses, and 17 cases of symmetrical pouch dilatation (SPD) (revision rate 4.4%). Teenage patients had a 22% revision rate for SPD. All revisions were completed laparoscopically with no mortality, no significant complications, and a median hospital stay of 1 day. The median weight loss following revisional surgery was not significantly different from the background cohort. SPD is the most common reason for revision of LAGB in this series. We postulate that SPD is caused by excessive pressure in the proximal gastric pouch. This may be generated either by eating too quickly or too large a volume or excessive tightening of the band. The radial forces in the pouch may ultimatel...Continue Reading

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Citations

Jan 13, 2010·Obesity Surgery·Paul Robert BurtonPaul E O'Brien
Sep 5, 2009·Obesity Surgery·Paul Robert BurtonPaul E O'Brien
Dec 25, 2010·Obesity Surgery·Richard John EganSally A Norton
Jun 17, 2010·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Jacques HimpensGiovanni Dapri
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Feb 22, 2018·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Sang-Yong Son, Yun Chan Park
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Dec 14, 2017·Obesity Surgery·Roshani Vijaykumar PatelWilliam James Buchanan Smellie
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