Band slippage after laparoscopic adjustable gastric banding: etiology and treatment

  • A. Keidar
  • A. Szold
  • E. Carmon
  • A. Blanc
  • S. Abu-AbeidEmail author
Original article



Laparoscopic adjustable gastric banding is a safe and effective procedure for the management of morbid obesity. However, band slippage is a common complication with variable presentation that can be rectified by a second laparoscopic procedure.


We studied case series of 125 consecutive patients who suffered from band slippage between November 1996 and May 2001 from a group of 1,480 laparoscopic adjustable gastric banding procedures performed during this time. The decision of whether to remove or replace/reposition the band was made prior to the operation, although the specific method used when replacement or repositioning was deemed suitable was determined by the operative findings. A laparoscopic approach was used in all but three patients.


A total of 125 patients (8.4%) suffered band slippage (posterior slippage, 82.4%; anterior slippage, 17.6%). In 70 patients (56%), the band was removed, whereas in 55 patients (44%) it was repositioned or replaced immediately. Of these 55 patients, six underwent later removal, five due to recurrent slippage and one due to erosion. Fourteen patients suffered complications, including gastric perforation (n = 8), intraoperative bleeding (n = 1), postoperative fever (n = 3), aspiration pneumonia (n = 1), upper gastrointestinal bleeding (n = 1), and pulmonary embolism (n = 1).


Band slippage is not a rare complication after laparoscopic adjustable gastric banding. The decision to remove or replace the band or convert to another bariatric procedure should be made preoperatively, taking both patient preference and etiology into consideration. Short-term results indicate that band salvage is successful when the patient population is chosen correctly.


Obesity Laparoscopic gastric banding Pouch dilatation Band slippage Band repositioning 


  1. 1.
    Abu-Abeid, S, Szold, A 1999Results and complications of laparoscopic adjustable gastric banding: an early and intermediate experienceObes Surg9188190PubMedGoogle Scholar
  2. 2.
    Abu-Abeid, S, Keidar, A, Gavert, N, Blanc, A, Szold, A 2003The clinical spectrum of band erosion following laparoscopic adjustable silicone gastric banding for morbid obesitySurg Endosc6861863Google Scholar
  3. 3.
    Belachew, M, Legrand, MJ, Defechereux, TH, Burtheret, MP, Jacquet, N 1994Laparoscopic adjustable silicone gastric banding in the treatment of morbid obesity: a preliminary reportSurg Endosc813541365PubMedGoogle Scholar
  4. 4.
    Belachew, M, Legrand, MJ, Vincent, V, Lismonde, M, Le Docte, N, Deschamps, V 1998Laparoscopic adjustable gastric bandingWorld J Surg22955963PubMedGoogle Scholar
  5. 5.
    Chelala, E, Cadiere, GB, Favretti, F, Himpens, J, Vertruyen, M, Bruyns, J, Maroquin, L,  et al. 1997Conversions and complications in 185 laparoscopic adjustable silicone gastric banding casesSurg Endosc11268271PubMedGoogle Scholar
  6. 6.
    Chevallier, JM, Zinzindohoue, F, Elian, N, Cherrak, A, Blanche, JP, Berta, JL, Altman, JJ,  et al. 2002Adjustable gastric banding in a public university hospital: prospective analysis of 400 patientsObes Surg129399PubMedGoogle Scholar
  7. 7.
    Consensus Development Conference Panel1991Gastrointestinal surgery for severe obesityAnn Intern Med115956996Google Scholar
  8. 8.
    Cottam, DR, Mattar, SG, Schauer, PR 2003Laparoscopic era of operations for morbid obesityArch Surg138367375CrossRefPubMedGoogle Scholar
  9. 9.
    Favretti, F, Cadiere, GB, Segato, G, Himpens, J, Busetto, L, Marchi, F, Vertruyen, M,  et al. 1997Laparoscopic adjustable gastric banding (Lap-Band): how to avoid complicationsObes Surg7352358PubMedGoogle Scholar
  10. 10.
    Hudson, SM, Dixon, JB, O’Brein, PE 2002Sweet eating is not a predictor of outcome after Lap-Band placement: can we finally bury the myth?Obes Surg12789794PubMedGoogle Scholar
  11. 11.
    Mason, EE 1992Gastric surgery for morbid obesitySurg Clin North Am72501513PubMedGoogle Scholar
  12. 12.
    O’Brein, PE, Brown, WA, Smith, A, McMurrick, PJ, Stephens, M 1999Prospective study of laparoscopically placed, adjustable gastric band in the treatment of morbid obesityBr J Surg85113118Google Scholar
  13. 13.
    Suter, M 2001Laparoscopic band repositioning for pouch dilatation after gastric banding: disappointing resultsObes Surg11507512PubMedGoogle Scholar
  14. 14.
    Suter, M, Bettschart, V, Giusti, V, Heraief, E, Jayet, A 2000A 3-year experience with laparoscopic gastric banding for obesitySurg Endosc14532536PubMedGoogle Scholar
  15. 15.
    Szold, A, Abu-Abeid, S 2002Laparoscopic adjustable silicone gastric banding for morbid obesity results and complications in 715 patientsSurg Endosc16230233PubMedGoogle Scholar
  16. 16.
    Szucs, RA, Turner, MA, Kellum, JM, Maria, EJ, Sugerman, HJ 1998Adjustable gastric band for the treatment of morbid obesity: radiologic evaluationAm J Roentgenol170993996Google Scholar
  17. 17.
    Wiesner, W, Weber, M, Hauser, RS, Hauser, M, Schoeb, O 2001Anterior versus posterior slippage: two different types of eccentric pouch dilatation in patients with adjustable laparoscopic gastric bandingDig Surg18182187PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2004

Authors and Affiliations

  • A. Keidar
    • 1
  • A. Szold
    • 2
  • E. Carmon
    • 1
  • A. Blanc
    • 3
  • S. Abu-Abeid
    • 2
    Email author
  1. 1.Department of Surgery BTel Aviv Sourasky Medical Center and the Sackler School of Medicine, Tel Aviv UniversityTel AvivIsrael
  2. 2.Advanced Endoscopic Surgery ServiceTel Aviv Sourasky Medical Center and the Sackler School of Medicine, Tel Aviv UniversityTel AvivIsrael
  3. 3.Department of RadiologyTel Aviv Sourasky Medical Center and the Sackler School of Medicine, Tel Aviv UniversityTel AvivIsrael

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