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Robot-assisted gastric band removal
Adjustable gastric banding (AGB) is one of the surgical treatment modalities for morbid obesity. Over the years, popularity for this treatment increased. It has been by far the most performed bariatric procedure for years in Europe and in the United States. Many gastric band removals are linked to complications and weight loss failure, indicating a new bariatric procedure for some of the patients. Complications after AGB are not uncommon and consist mainly of gastroesophageal reflux disease, pouch dilatation, slippage of the band, and intragastric migration. The failure of the gastric band is multifactorial. Gastric band removal does not preclude a new bariatric procedure (the most common procedure performed in our department is Roux en-Y gastric bypass), which is feasible in the same operative time but the 2-step approach is suitable. The new bariatric procedure offers adequate surgical outcomes and satisfactory results in terms of weight loss.
M Nedelcu, A D'Urso, HA Mercoli, M Vix, D Mutter, J Marescaux
Surgical intervention
4 years ago
1086 views
36 likes
0 comments
08:14
Robot-assisted gastric band removal
Adjustable gastric banding (AGB) is one of the surgical treatment modalities for morbid obesity. Over the years, popularity for this treatment increased. It has been by far the most performed bariatric procedure for years in Europe and in the United States. Many gastric band removals are linked to complications and weight loss failure, indicating a new bariatric procedure for some of the patients. Complications after AGB are not uncommon and consist mainly of gastroesophageal reflux disease, pouch dilatation, slippage of the band, and intragastric migration. The failure of the gastric band is multifactorial. Gastric band removal does not preclude a new bariatric procedure (the most common procedure performed in our department is Roux en-Y gastric bypass), which is feasible in the same operative time but the 2-step approach is suitable. The new bariatric procedure offers adequate surgical outcomes and satisfactory results in terms of weight loss.
Robot-assisted gastric band removal: any limitations?
Nowadays, indications for gastric band removal are well-standardized. In case of esophageal or gastric dilatation, migration or any injury related to the LAP-BAND® access port or tubing, the band and its access port should be removed. In rare specific cases, part of the LAP-BAND® system (either access port or band) may be preserved.
Before proceeding to the surgical band removal, a complete preoperative radiological and endoscopic work-up should be performed.
Here, we present the case of a 62-year-old woman who benefited from gastric band placement 10 years earlier. The band proved effective. However, for several weeks, she has been suffering from abdominal pain associated with vomiting and hematemesis.
After a work-up which included CT-scanning, water-soluble contrast swallow and gastroscopy, it was decided to remove the band.
L Marx, M Vix, A D'Urso, J Marescaux
Surgical intervention
5 years ago
763 views
11 likes
0 comments
08:36
Robot-assisted gastric band removal: any limitations?
Nowadays, indications for gastric band removal are well-standardized. In case of esophageal or gastric dilatation, migration or any injury related to the LAP-BAND® access port or tubing, the band and its access port should be removed. In rare specific cases, part of the LAP-BAND® system (either access port or band) may be preserved.
Before proceeding to the surgical band removal, a complete preoperative radiological and endoscopic work-up should be performed.
Here, we present the case of a 62-year-old woman who benefited from gastric band placement 10 years earlier. The band proved effective. However, for several weeks, she has been suffering from abdominal pain associated with vomiting and hematemesis.
After a work-up which included CT-scanning, water-soluble contrast swallow and gastroscopy, it was decided to remove the band.
Gastric band removal for weight regain
Patients with a gastric band frequently request for its removal when it becomes inefficient in order to envisage another bariatric procedure. The intervention consists in the dissection of several adhesions between the liver and the stomach, the freeing of the gastric wrap, and the band removal. This procedure may be made uneasy because of the abundance and tightness of adhesions. In a few cases, our team has performed another procedure at the same time but usually we delay the second procedure in order to reduce complication risks, and more particularly anastomotic risks linked to this new intervention. The second interventions should be performed at least 2 months apart in order to allow for proper scarring of the gastric wall which harboured the band.
M Vix, J Marescaux
Surgical intervention
6 years ago
2395 views
19 likes
0 comments
05:25
Gastric band removal for weight regain
Patients with a gastric band frequently request for its removal when it becomes inefficient in order to envisage another bariatric procedure. The intervention consists in the dissection of several adhesions between the liver and the stomach, the freeing of the gastric wrap, and the band removal. This procedure may be made uneasy because of the abundance and tightness of adhesions. In a few cases, our team has performed another procedure at the same time but usually we delay the second procedure in order to reduce complication risks, and more particularly anastomotic risks linked to this new intervention. The second interventions should be performed at least 2 months apart in order to allow for proper scarring of the gastric wall which harboured the band.
Perigastric band abscess: laparoscopic approach
Band infection after gastric banding is a relatively rare complication. In most cases, it manifests itself through abdominal pain associated with fever, and/or an abscess surrounding the access port. This is the case of a 37-year-old female patient in whom a gastric band was placed 5 years ago. The patient lost 60% of her excess weight; however, she complained that the gastric band was no longer as efficient. Imaging studies allowed to identify the existence of a 50mL supragastric pouch. A gastroscopy reveals nothing unusual.
Following this postoperative control, we decided to remove the patient’s gastric band as she was troubled by the superior gastric pouch.
M Vix, F Costantino, J Marescaux
Surgical intervention
9 years ago
229 views
21 likes
0 comments
06:13
Perigastric band abscess: laparoscopic approach
Band infection after gastric banding is a relatively rare complication. In most cases, it manifests itself through abdominal pain associated with fever, and/or an abscess surrounding the access port. This is the case of a 37-year-old female patient in whom a gastric band was placed 5 years ago. The patient lost 60% of her excess weight; however, she complained that the gastric band was no longer as efficient. Imaging studies allowed to identify the existence of a 50mL supragastric pouch. A gastroscopy reveals nothing unusual.
Following this postoperative control, we decided to remove the patient’s gastric band as she was troubled by the superior gastric pouch.
Single Incision Laparoscopic Surgery (SILS): gastric banding removal for acute gastric pouch dilatation
In a significantly short time, Laparoscopic Adjustable Gastric Banding (LAGB) for morbid obesity has become a common operation in Europe and elsewhere.
Recent series show a high percentage of patients re-operated on, almost always with excision of the banding system. The reasons for re-operation are esophagitis, band erosion, pouch dilatation, leakage from the balloon, and esophageal dilatation.
This video demonstrates the removal of a gastric band for acute gastric pouch dilatation. The procedure was completed using a single access technique, with conventional laparoscopic instrumentation. A 2cm incision is performed on the port site and the same one is removed first maintaining the connection tube on site in order to place traction on the band. A 10mm port is inserted using an open technique, and two further 5mm ports are placed anteriorly just to the left and to the right side of the previous one.
N Perrotta, A Cappiello, C Giudicianni, N Andriulo, T Marinelli, D Loffredo
Surgical intervention
9 years ago
2935 views
8 likes
0 comments
06:06
Single Incision Laparoscopic Surgery (SILS): gastric banding removal for acute gastric pouch dilatation
In a significantly short time, Laparoscopic Adjustable Gastric Banding (LAGB) for morbid obesity has become a common operation in Europe and elsewhere.
Recent series show a high percentage of patients re-operated on, almost always with excision of the banding system. The reasons for re-operation are esophagitis, band erosion, pouch dilatation, leakage from the balloon, and esophageal dilatation.
This video demonstrates the removal of a gastric band for acute gastric pouch dilatation. The procedure was completed using a single access technique, with conventional laparoscopic instrumentation. A 2cm incision is performed on the port site and the same one is removed first maintaining the connection tube on site in order to place traction on the band. A 10mm port is inserted using an open technique, and two further 5mm ports are placed anteriorly just to the left and to the right side of the previous one.
Laparoscopic gastric banding in a female patient with a BMI=40
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.
M Vix
Surgical intervention
12 years ago
1062 views
20 likes
0 comments
09:16
Laparoscopic gastric banding in a female patient with a BMI=40
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.