Prevention of pouch dilatation after laparoscopic adjustable gastric banding

Marco Antonio Zappa, Giancarlo Micheletto, Ezio Lattuada, Enrico Mozzi, Alessandra Spinola, Massimo Meco, Giancarlo Roviaro, Santo Bressani Doldi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The major long-term complication of laparoscopic adjustable gastric banding (LAGB) is dilatation of the gastric pouch, that is reported with a frequency ranging from 1 to 25%, and often requires removal of the band. In addition to the usual recommendations of bariatric surgery centers and dietetic advice to prevent this complication, over the last 4 years we introduced a technical modification of the procedure. Methods: From Nov 1993 to Dec 2004, 684 morbidly obese patients underwent adjustable gastric banding, 83 patients by open surgery and 601 patients by laparoscopy. The first 323 patients (group A) were operated by the perigastric approach, and 57 patients (group B) were operated by the pars flaccida approach. Since Dec 2000, 304 patients (group C) were operated with a modified pars flaccida technique, which consisted in suturing the gastric lesser curvature below the band with one or two stitches to the right phrenic crus to secure the band in place. Results: In group A, the most important late complication was irreversible dilatation of the gastric pouch, which occurred in 35 patients (10.8%), and required removal of the band in 30 cases and replacement in 5. In group B, there were 3 pouch dilatations (5.2%). In group C, only 4 dilatations occurred (1.31%), which required 3 band removals and 1 band replacement Conclusion: Dilatation of the gastric pouch appears to be dramatically reduced by our minor technical modification of band placement.

Original languageEnglish
Pages (from-to)132-136
Number of pages5
JournalObesity Surgery
Volume16
Issue number2
DOIs
Publication statusPublished - Feb 2006

Keywords

  • Bariatric surgery
  • Gastric pouch dilatation
  • Laparoscopic adjustable gastric banding
  • Morbid obesity

ASJC Scopus subject areas

  • Surgery

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