Abstract
Laparoscopic adjustable gastric banding (LAGB) surgery, developed to address the shortcomings of the vertical banded gastroplasty and fixed gastric band procedures, is now established as a safe and well-standardized bariatric-metabolic surgical procedure. The safety and complication profiles are well known: Complications are often prevented, and long-term sustained weight loss is documented. Standardization and reproducibility are attributes of all quality interventional care programs, and these attributes should be the signature of a successful LAGB practice.
Surgical access is optimized with the use of preoperative weight loss, careful patient positioning, and excellent liver retraction. The diaphragmatic hiatus is explored and repaired when indicated. The pars flaccida technique is used to generate the retrogastric tunnel, and the band is positioned accurately in relation to the gastroesophageal junction. Fixation of the band to prevent anterior gastric prolapse is recommended, and the access port is fixed to fascia to allow easy access.
LAGB surgery can be used to enhance the outcomes of vertical banded gastroplasty, Roux-en-Y gastric bypass, and sleeve gastrectomy if weight regain or poor weight loss is experienced, and a suitable abnormality of gastric anatomy is present. Meticulous band placement and aftercare are the essential requirements of all LAGB programs.
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References
Dixon JB, Straznicky NE, Lambert EA, Schlaich MP, Lambert GW. Laparoscopic adjustable gastric banding and other devices for the management of obesity. Circulation. 2012;126(6):774–85.
O’Brien PE, Dixon JB, Laurie C, Anderson M. A prospective randomized trial of placement of the laparoscopic adjustable gastric band: comparison of the perigastric and pars flaccida pathways. Obes Surg. 2005;15(6):820–6.
Cobourn C, Mumford D, Chapman MA, Wells L. Laparoscopic gastric banding is safe in outpatient surgical centers. Obes Surg. 2010;20(4):415–22.
Dixon JB, Cobourn CS. Exploration of esophageal hiatus: does crural repair reduce proximal pouch distension? Surg Obes Relat Dis. 2013;9(3):350–5.
Singhal R, Kitchen M, Ndirika S, Hunt K, Bridgwater S, Super P. The “Birmingham stitch” – avoiding slippage in laparoscopic gastric banding. Obes Surg. 2008;18(4):359–63.
Randhawa S, Ghai P, Bhoyrul S. Port fixation during gastric banding: 4-year outcome using a synthetic mesh. Surg Obes Relat Dis. 2013;9(2):296–9.
Miller KA, Pump A. Mechanical versus suture fixation of the port in adjustable gastric banding procedures: a prospective randomized blinded study. Surg Endosc. 2008;22(11):2478–84.
O’Brien P, Brown W, Dixon J. Revisional surgery for morbid obesity-conversion to the Lap-Band system. Obes Surg. 2000;10(6):557–63.
Bessler M, Daud A, DiGiorgi MF, Inabnet WB, Schrope B, Olivero-Rivera L, et al. Adjustable gastric banding as revisional bariatric procedure after failed gastric bypass – intermediate results. Surg Obes Relat Dis. 2010;6(1):31–5.
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The technique of laparoscopic adjustable gastric banding (MPEG 274872 kb)
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Cobourn, C.S., Dixon, J.B. (2023). Laparoscopic Adjustable Gastric Banding: The Technique. In: Agrawal, S. (eds) Obesity, Bariatric and Metabolic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-60596-4_30
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DOI: https://doi.org/10.1007/978-3-030-60596-4_30
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