Removal of Peri-Gastric Fat Prevents Acute Obstruction after Lap-Band® Surgery

Abstract

Routine removal of peri-gastric fat pads when using the pars flaccida technique for Lap Band surgery appears to prevent postoperative esophageal obstruction.

U.S. experience with 749 laparoscopic adjustable gastric bands: intermediate outcomes

“…After routine removal of all perigastric fat pads around the gastroesophageal junction, we no longer have seen early band obstructions. Complete resection of the perigastric fat pads precludes incorporation of visceral fat within the band, thus preventing external compression on the stomach and subsequent stomal obstruction [10]. In addition, the use of the larger Vanguard band, which carries a slightly larger circumference of 11 cm, has been instrumental in avoiding stomal obstruction, particularly in the superobese.…”

“…In addition, after the first 143 bands had been placed, the perigastric fat pads were consistently removed to avoid the complication of acute stomal obstruction [10]. No saline was injected into the band at the time of the operation.…”

Hiatal hernia repair at the initial laparoscopic adjustable gastric band operation reduces the need for reoperation

“…Anterior perigastric fat pads were consistently removed to avoid stomal obstruction, and to allow good visualization of the gastric pouch for accurate suture placement [14]. Hollow tubing connected the band to a subcutaneous reservoir port, which was secured to anterior rectus sheath in a midabdominal location.…”

Gastric banding as a salvage procedure for patients with weight loss failure after Roux-en-Y gastric bypass

“…The band was drawn around the pouch and locked into place. Any perigastric fat pads were removed to avoid the possible complication of acute stomal obstruction and to delineate the gastric wall for adequate suturing [15]. Anterior fixation of the band involved suturing the gastric remnant to the gastric pouch above the band with nonabsorbable sutures.…”