Internal hernia due to adjustable gastric band tubing: review of the literature and illustrative case video



Laparoscopic adjustable gastric banding (LAGB) is a commonly performed bariatric procedure. Device-related morbidity is typically associated with the subcutaneous port or the band itself. Complications related to band tubing are unusual. Small bowel obstruction (SBO) after LAGB is a unique and serious complication; there is the potential of delayed diagnosis and the risk of closed-loop bowel obstruction. SBO secondary to internal hernia caused by band tubing is very rare, with only five cases reported in the literature.


In this article, we describe our experience and provide an illustrative video of a case of SBO related to band tubing. We also provide a detailed review of the few previously published case reports.


Based on the common features of our case and other published case reports, we hypothesize some risk factors that might lead to this unique morbidity of adjustable gastric band tubing and provide potential solutions to prevent this problem.


Tubing-related SBO is a serious complication with the risk of closed-loop bowel obstruction. Urgent operative exploration is required to avoid bowel strangulation. To prevent recurrence we advise functionally shortening the tubing by tucking it to the right upper quadrant above the liver and also provide some omental coverage between the bowel and band tubing if possible.

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Drs. Hamed, Simpson, LoMenzo, and Kligman have no conflicts of interest or financial ties to disclose.

Author information

Correspondence to Osama H. Hamed.

Additional information

This video was accepted for the Video Channel at SAGES 2012, San Diego CA, May 7–10, 2012 (abstract ID 36575).

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Supplementary material 1 (MPG 84080 kb)

Supplementary material 1 (MPG 84080 kb)

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Hamed, O.H., Simpson, L., LoMenzo, E. et al. Internal hernia due to adjustable gastric band tubing: review of the literature and illustrative case video. Surg Endosc 27, 4378–4382 (2013).

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  • Band tubing
  • Internal hernia
  • Small bowel obstruction
  • Laparoscopic band