IS Case 396: Laparoscopic adjustable gastric band

Jeremy Sykes, MD


2009 URMC Imaging Sciences
Publication Date: 2010-03-09

History

Patient is a 44-year-old female, status-post lap band surgery two years ago, with gastroesophageal reflux.

Findings

See Images

Discussion

A laparoscopic adjustable gastric band is a restrictive device implanted via laparoscopic bariatric surgery and designed for obese patients. It consists of a silicone band with an inflatable inner cuff connected by silicone tubing to an implanted subcutaneous injection port, which is sutured in the anterior rectus sheath. The band is placed around the upper portion of the stomach to create a small upper pouch with a stoma to the remainder of the stomach. The pouch holds approximately 110 to 220 grams of food each meal, which helps the patient feel hungry less often.

Indications include a body mass index of 40 or greater, or between 35–40 in cases of patients with certain comorbidities that are known to improve with weight loss, such as sleep apnea, diabetes, osteoarthritis, GERD, or metabolic syndrome. Some patients who undergo adjustable gastric band surgery lose more than 60% of excess body weight.

Some complications may include slippage of the band or migration of the access port, which may require reoperation. Erosion of the band into the stomach has also been reported.

References

  1. Szucs RA, Turner MA, Kellum JM, DeMaria EJ, Sugerman HJ. Adjustable laparoscopic gastric band for the treatment of morbid obesity: radiologic evaluation. AJR Am J Roentgenol. 1998 Apr;170(4):993-6. PMID: 9530049
  2. Mortelé KJ, Pattijn P, Mollet P, et al.The Swedish laparoscopic adjustable gastric banding for morbid obesity: radiologic findings in 218 patients. AJR Am J Roentgenol. 2001 Jul;177(1):77-84. PMID: 11418402

5 images