Laparoscopic Gastric Plication As a Revisional Procedure After Failed Adjustable Gastric Band

John H Rodriguez, MD, Stacy Brethauer, MD, Matthew Kroh, MD. Cleveland Clinic Foundation


 INTRODUCTION: Laparoscopic adjustable gastric banding (LAGB) is one of the most common weight loss operations performed. Despite it’s popularity, well known complications requiring re-operation are frequently encountered. Revision of the band or conversion to other procedures including Roux en-Y gastric bypass and sleeve gastrectomy are well described. More recently, laparoscopic gastric plication has been introduced as a safe and effective restrictive weight loss procedure. We present two cases of failed LAGB conversion to gastric plication. 

CASE REPORT: Two patients developed band-related complications requiring re-operation. Both declined or were ineligible for conversion to bypass or sleeve gastrectomy. Case #1 is a 41 y/o female who developed intractable dysphagia following LAGB and primary failure of weight loss. Case #2 is a 29 y/o female with band erosion. Both patients required operation for band removal. After band removal, greater curvature plication was performed as a revisional bariatric salvage procedure. Both cases were successfully completed laparoscopically. Both patients experienced satisfactory outcomes regarding post-operative recovery and weight loss.
CONCLUSION: Laparoscopic greater curvature plication is an optional procedure for patients presenting with LAGB complications requiring revisional surgery. As we gain experience with this novel procedure, application and results need to be carefully examined.

Session Number: Poster – Poster Presentations
Program Number: P497
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