Laparoscopic Conversion of Laparoscopic Adjustable Gastric Banding (lagb) to Sleeve Gastrectomy (lsg) for Morbid Obesity

Background: We present a case of a laparoscopic conversion of a LAGB to a LSG.

Case Report: A 54-year-old female with a history of prior LAGB for morbid obesity presented with failure of weight loss, recurrent nausea, vomiting and weight regain. Upper GI series revealed posterior slippage of the stomach and a small hiatal hernia with gastroesophageal reflux. The patient underwent a laparoscopic conversion of the LAGB to LSG. After repair of a small hiatal hernia the band was removed and a LSG performed. On postoperative day 1, the patient underwent a gastrographin swallow that showed a hold up of contrast at the level of the gastroesophageal junction. Subsequently, the patient complained of nausea, vomiting, and inability to tolerate fluids. On postoperative day 2, an upper endoscopy revealed neither stenosis nor stricture. The patient was continued on intravenous fluids and proton pump inhibitors. On postoperative day 4, an upper GI study was repeated confirming adequate passage of contrast. The patient continued to improve and was discharged, tolerating liquid diet.

Conclusion: LABG slippage is not an infrequent complication; conversion to LSG appears to be a feasible option. Attention has to be given to a possible narrowing of the gastric inlet in patients after LAGB.

Session: Video Channel

Program Number: V062

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