Skip to main content
SpringerLink
Log in

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

  • Video
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Mitermair RP, Weiss H, Nehoda H, Kirchmayr W, Aigner F (2003) Laparoscopic Swedish adjustable gastric banding: 6-year follow up and comparison to other laparoscopic bariatric procedures. Obes Surg 13:412–417

    Article  Google Scholar 

  2. Ren CJ, Horgan S, Ponce J (2002) U.S. experience with the Lap-Band system. Am J Surg 184:46S–50S

    Article  PubMed  Google Scholar 

  3. Deitel M, Shikora SA (2002) The development of the surgical treatment of morbid obesity. J Am Coll Nutr 21:365–371

    Article  PubMed  Google Scholar 

  4. Susmallian S, Ezri T, Elis M, Charuzi I (2003) Access-port complications after laparoscopic gastric banding. Obes Surg 13:128–131

    Article  PubMed  Google Scholar 

  5. Keidar A, Carmon E, Szold A, Abu-Abeid S (2005) Port complications following laparoscopic adjustable gastric banding for morbid obesity. Obes Surg 15:361–365

    Article  PubMed  Google Scholar 

  6. Niville E, Dams A, Vlasselaers J (2001) Lap-Band erosion: incidence and treatment. Obes Surg 11:744–747

    Article  PubMed  CAS  Google Scholar 

  7. Suter M (2001) Laparoscopic band repositioning for pouch dilatation/slippage after gastric banding: disappointing results. Obes Surg 11:507–512

    Article  PubMed  CAS  Google Scholar 

  8. U.S. Food and Drug Administration, Center for Devices and Radiological Health (2008) LAP-BAND adjustable gastric banding (LAGB) system—P000008b. www.fda.gov/cdrh/pdf/p000008b.pdf. Accessed 1 Dec 2008

  9. Spivak H, Favretti F (2002) Avoiding postoperative complications with the LAP-BAND system. Am J Surg 184:31S–37S

    Article  PubMed  Google Scholar 

  10. Favretti F, Cadiere GB, Segato G et al (2002) Laparoscopic banding: selection and technique in 830 patients. Obes Surg 12:385–390

    Article  PubMed  CAS  Google Scholar 

  11. Zappa MA, Micheletto G, Lattuada E et al (2006) Prevention of pouch dilatation after laparoscopic adjustable gastric banding. Obes Surg 16:132–136

    Article  PubMed  Google Scholar 

  12. Sathyanarayana S, Wylen EL, Baskaya MK, Nanda A (2000) Spontaneous bowel perforation after ventriculoperitoneal shunt surgery: case report and review of 45 cases. Surg Neurol 54:388–396

    Article  PubMed  CAS  Google Scholar 

  13. Snow RB, Lavyne MH, Fraser RAR (1986) Colonic perforation by ventriculoperitoneal shunts. Surg Neurol 25:173–177

    Article  PubMed  CAS  Google Scholar 

  14. Zengin K, Sen B, Ozben V, Taskin M (2006) Detachment of the connecting tube from the port and migration into jejunal wall. Obes Surg 16:206–207

    Article  PubMed  Google Scholar 

  15. Hartmann J, Scharfenberg M, Paul M, Ablassmaier B (2006) Intracolonic penetration of the laparoscopic adjustable gastric banding tube. Obes Surg 16:203–205

    Article  PubMed  Google Scholar 

  16. Campbell NA, Brown WA, Smith AI, Skinner S, Nottle P (2008) Small bowel obstruction creates a closed loop in patients with a laparoscopic adjustable gastric band. Obes Surg 18:1346–1349

    Article  PubMed  Google Scholar 

  17. Catel L, Lefevre F, Lauren V et al (2003) Small bowel obstruction from adhesions: which CT severity criteria to research? J Radiol 84:27–31

    PubMed  CAS  Google Scholar 

  18. Egbeare DM, Myers AF, Lawrence RJ (2008) Small bowel obstruction secondary to intragastric erosion and migration of a gastric band. J Gastrointest Surg 12:983–984

    Article  PubMed  CAS  Google Scholar 

  19. Bueter M, Thalheimer A, Meyer D, Fein M (2006) Band erosion and passage, causing small bowel obstruction. Obes Surg 16:1679–1682

    Article  PubMed  Google Scholar 

  20. DeNino WF, Forgione PM (2010) Small bowel obstruction from small bowel volvulus and gram-positive peritonitis in laparoscopic adjustable gastric banding. Surg Obes Relat Dis 6:211–212

    Article  PubMed  Google Scholar 

  21. Strobos E, Antanavicius G, Josloff R (2009) Unusual complication: small bowel obstruction caused by tubing of gastric band. Surg Obes Relat Dis 5:637–640

    Article  PubMed  Google Scholar 

  22. Zappa MA, Lattuada E, Mozzi E et al (2006) An unusual complication of gastric banding: recurrent small bowel obstruction caused by the connecting tube. Obes Surg 16:939–941

    Article  PubMed  CAS  Google Scholar 

  23. Shipkov CD, Uchikov AP, Uchikov EH (2004) Small bowel obstruction by the silicone tube of the gastric band. Obes Surg 9:1280–1282

    Article  Google Scholar 

  24. Mills JK, Zakon J, Hung Nguyen M (2008) Images for surgeons. Strangulation of the small bowel mesentery and internal hernia due to the connection tube of a gastric band. ANZ J Surg 78:1128–1129

    Article  PubMed  Google Scholar 

  25. Ng KM, Thompson G (2009) Case report: laparoscopic adjustable gastric band tubing: unusual cause of an internal hernia. Surg Obes Relat Dis 5:517–518

    Article  PubMed  Google Scholar 

  26. Agahi A, Harle R (2009) Case report: a serious but rare complication of laparoscopic adjustable gastric banding: bowel obstruction due to caecal volvulus. Obes Surg 19:1197–1200

    Article  PubMed  Google Scholar 

  27. Consumer Guide to Bariatric Surgery, Adjustable Gastric Banding (2010). http://www.yourbariatricsurgeryguide.com/gastric-banding/. Accessed 8 July 2010

Download references

Disclosures

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

Author information

Authors and Affiliations

  1. Department of Surgery, King Hussein Cancer Center, 202 Queen Rania Alabdullah Street, P.O. Box 1269, Amman, 11942, Jordan

    Osama H. Hamed

  2. Department of Surgery, University of Maryland, Baltimore, MD, USA

    Lashondria Simpson & Mark D. Kligman

  3. Department of Surgery, Cleveland Clinic Florida, Weston, FL, USA

    Emanuele LoMenzo

Authors
  1. Osama H. Hamed
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lashondria Simpson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Emanuele LoMenzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark D. Kligman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

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).

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (MPG 84080 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

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). https://doi.org/10.1007/s00464-013-3024-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-013-3024-2

Keywords

Search

Navigation