A rare complication of laparoscopic adjustable gastric banding procedure: Opening of band (horseshoe view)
İbrahim Sakçak1, Fatih Mehmet Avşar1, Enver Okan Hamamcı1, Settar Bostanoğlu1, Muhittin Sonışık1, Akın Bostanoğlu1, Nihal Zekiye Erdem2, Erdal Coşgun3
1Ankara Numune Eğitim ve Araştırma Hastanesi, 6. Cerrahi Kliniği, Ankara, Türkiye
2Ankara Numune Eğitim ve Araştırma Hastanesi, Beslenme ve Diyetetik Bölümü, Ankara, Türkiye
3Hacettepe Üniversitesi, Biyoistatistik Anabilim Dalı, Ankara, Türkiye
Purpose: In the present study, the reasons for band release, a rarely encountered complication, as well as the ways to prevent opening of band, were determined in patients who had undergone laparoscopic adjustable gastric band (LAGB) surgery.
Materials and Methods: LAGB was performed for suitable patients. The patients were re-evaluated at each visit. Patients who were thought not to have lost an adequate amount of weight had a barium contrast gastroduodenal radiograph and/or direct radiograph following administration of an opaque substance through the port. Friedman test was used to evaluate the percentage of excess weight loss (EWL) and the percentage of recovery (PCV).
Results: LAGB surgery was performed in 101 cases using the pars flaccida technique. 94 patients were included in the study. The mean age of the patients was 27 years (range, 18-55 years), and the mean follow-up period was 23 months (range, 2-31 months). BMI was 44 kg/m2 (37-62 kg/m2), EWL was 52.6% (p<0.05), and PRC was 52.3% (p<0.05). Opening of band occurred in 4 patients. Three of the 4 patients underwent a Roux-en-Y gastroenterostomy (RYGE) procedure, whereas, the band of 1 patient was relocked.
Conclusion: LAGB is an effective and safe surgical technique in the treatment of obesity. However, the efficacy of the treatment is influenced by technical problems, such as opening of band. Opening of band can be easily diagnosed on the opaque radiographs. When this event occurs, the band should be relocked or a malabsorptive procedure should be performed.
Keywords: Morbid obesity, bariatric surgery, laparoscopy, gastric banding, opening of band