Laparoscopic gastric banding in a female patient with a BMI=40
Epublication WebSurg.com, May 2007;07(05). URL: http://websurg.com/doi/vd01en2110
This video demonstrates the elegant pars flaccida approach to place an adjustable gastric band around the cardia of the stomach. A retrogastric tunnel is created by blunt dissection but always under visual control to minimize complications such as vascular and gastric injury. This video is suitable for digestive and bariatric surgeons. This video shows the case of a patient with a BMI of 40 and a long history of morbid obesity despite numerous diets and behavioral studies that have all failed. The preoperative assessment was performed by associating endocrine, cardiac and psychiatric evaluations. The procedure consists in fitting an inflatable gastric band (BioEnterics® Lap-Band® System) around the superior portion of the stomach. Five trocars are used (1 of 12 mm and 4 of 5 mm). A 15 mL bag must be left touching the esophagus. This video describes the dissection of a retrogastric tunnel entirely under visual control, followed by the gastric band fitting and the covering of the band by a gastric wrap. This video demonstrates an elegant approach for placing a gastric band around the cardia. The patient is a woman with a BMI of 40. Using 5 trocars (1 of 12-mm, 4 of 5-mm), the author describes the dissection of a retrogastric tunnel under visual control. After creating the retrogastric tunnel, the author places the noninsufflated gastric band (Lap-Band System, Allergan, Inc, Irvine, CA) in the abdomen. Using a lateral trocar through the camera port, the author gently pulls the tip of the catheter and then the band through the posterior gastric channel with the grasper. The procedure continues with the use of a gastric wrap to cover the band.