Laparoscopic gastric band removal

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Laparoscopic gastric band removal

Authors

M Vix, J Marescaux

Media type

Surgical video

Duration

04'00''

Publication

2005-05

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E-publication

WeBSurg.com, May 2005;5(05).
URL: http://www.websurg.com/doi-vd01en1604e.htm

Laparoscopic gastric band removal

1. Adhesiolysis 00'08''

This video will demonstrate the laparoscopic removal of a gastric band. The case is that of a male patient who successfully lost weight for 2 years after the original operation. His BMI dropped from 35 to 28. He was then admitted to hospital in emergency with acute dysphagia. Endoscopy and contrast study revealed that the banding was in an incorrect position with the mechanical stenosis of the distal part of the gastric pouch and a little slippage of the stomach under the band. The decision was then made to remove the gastric band. Following the division of the adhesions between the liver and the stomach, the tube part of the gastric band is grasped. The dissection is then continued towards the band in order to fully mobilize the gastric band. More adhesions between the lesser curve of the stomach and the liver need to be divided to get the correct exposure. We now come to the area of the band.

2. Dissection of band 01'17''

The white plastic is visible. Gentle coagulation is used to separate the tissues overlying the band. The junction between the tube and the band itself is now visible. This is the point which needs to be divided in order to completely free the band.

3. Cutting of band 01'50''

The plastic is easily divided using scissors. Once divided, the end of the band is grasped and gently withdrawn from the posterior gastric space. It is then placed in an endobag ready for retrieval. Further dissection is necessary to free the end of the tubal part of the band.

4. Extraction 02'53''

Once this is free, this is also placed in the endobag. The bag is then closed and withdrawn from the abdominal cavity. A final check is made for hemostasis and this is the end of the procedure.