title: Laparoscopic adjustable silicone gastric banding (Lap-Band): how to avoid complications.
abstract: BACKGROUND
  The laparoscopic application of LAP-BAND is gaining widespread acceptance as a gastric restrictive procedure. At the same time the reported morbidities (i.e., gastric perforation, stomach and/or band slippage) are cause for some concern.
  
  
  METHODS
  From September 1993 until May 1997, 260 patients underwent LAP-BAND at the Department of Surgery at the University of Padova, Italy.
  
  
  RESULTS
  The mortality rate was zero and the morbidity rate requiring reoperation was 3.4% (stomach slippage, gastric perforation, erosion). In order to avoid complications the key points of the technique are reviewed: (1) reference points for dissection (equator of the balloon, left crus); (2) retrogastric tunnel within the layers of the phrenogastric ligament; (3) embedment of the band; (4) proper outlet calibration; and (5) retention sutures.
  
  
  CONCLUSIONS
  Attention to technical details is of paramount importance for a safe, standardized and effective operation.
authors.affiliation: Department of Surgery, University of Padova, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Favretti
authors.forename: G B
authors.initials: GB
authors.lastname: Cadiere
authors.forename: G
authors.initials: G
authors.lastname: Segato
authors.forename: J
authors.initials: J
authors.lastname: Himpens
authors.forename: L
authors.initials: L
authors.lastname: Busetto
authors.forename: F
authors.initials: F
authors.lastname: De Marchi
authors.forename: M
authors.initials: M
authors.lastname: Vertruyen
authors.forename: G
authors.initials: G
authors.lastname: Enzi
authors.forename: M
authors.initials: M
authors.lastname: De Luca
authors.forename: M
authors.initials: M
authors.lastname: Lise
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004210:Dissection; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008022:Ligaments / Q000033:anatomy & histology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D012086:Reoperation; D012828:Silicones; D013270:Stomach / Q000293:injuries / Q000473:pathology; D013536:Suture Techniques
chemical_list: D012828:Silicones