A step-by-step guide to placement of the LAP-BAND adjustable gastric banding system.
نویسندگان
چکیده
The early promise of laparoscopic adjustable gastric banding was tempered by reports of high rates of gastric herniation or prolapse. These complications are a function of the operative technique used early on. At the time, in the early 1990s, the LAP-BAND device (INAMED Health, Santa Barbara, CA) was placed lower on the stomach, near the first short gastric vessel. The required perigastric dissection was difficult and variable in its extent, depending on the width of the stomach and where the surgeon began the dissection. To combat these problems, a new surgical method for placement of the band has evolved. Called the pars flaccida technique, it emphasizes minimal dissection and placement of the LAP-BAND out of the lesser sac. This leads to a higher position of the band, away from the body of the stomach. The technique serves to make band placement simple, safe, reproducible, and easily teachable, as well as to decrease the rate of gastric herniation or prolapse. Keeping the band out of the lesser sac, away from the peristalsing stomach, minimizing dissection of the attachments to the stomach, paying strict attention to gastric-to-gastric suturing, and leaving all fluid out of the band until at least 6 weeks after surgery appear to be the most important factors in reducing the incidence of this complication.
منابع مشابه
Patient management after LAP-BAND placement.
Severe obesity is a chronic disease requiring continuing care. Optimal outcomes of laparoscopic adjustable gastric banding using the LAP-BAND (INAMED Health, Santa Barbara, CA) depend on accurate placement of the band and excellent postplacement care, which requires a long-term commitment from both the patient and the bariatric surgical team. Adjustability is a key feature of the LAP-BAND syste...
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Background: Morbid obesity contributes to many health risks including physical, emotional, and social problems. The increasing prevalence of obesity is a major public health concern since obesity is associated with several chronic diseases. Morbid obesity is one of the biggest independent risk factors for early mortality. Various options for the surgical treatment of morbid obesity have bee...
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متن کاملBariatric Surgery | Clinical Review Criteria
© 1999 Kaiser Foundation Health Plan of Washington. All Rights Reserved. . Back to Top Kaiser Foundation Health Plan of Washington Clinical Review Criteria Bariatric Surgery Adjustable gastric banding, Laparoscopic or Open (Lap Band) EndoGastric Solutions Stomaphy XTM Endoluminal Fastener Gastric Bypass for GERD Gastric Electrical Stimulator Intragastric Balloons Laparoscopic Sleeve...
متن کاملPii: S0002-9610(02)01180-7
Laparoscopic adjustable gastric banding is the most commonly performed operation for morbid obesity in Europe and Australia and has been shown to result in significant long-term weight loss. The US Food and Drug Administration (FDA)–monitored clinical trial results with the LAP-BAND system (INAMED Health, Santa Barbara, CA) did not reproduce the results of studies performed elsewhere in the wor...
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ورودعنوان ژورنال:
- American journal of surgery
دوره 184 6B شماره
صفحات -
تاریخ انتشار 2002