title: Laparoscopic insertion of a gastric band for weight gain following laparoscopic Roux-en-Y Gastric bypass: description of the technique.
abstract: BACKGROUND
  A recently published prospective series has demonstrated that weight loss ceases 18 to 24 months following Laparoscopic Roux-en-Y gastric bypass (RYGB) and that, by 48 months, there is significant weight regain in 50% of patients.
  
  
  METHODS
  We report the case of a 38-year-old male patient who developed significant weight regain 42 months following laparoscopic (RYGB) and underwent laparoscopic placement of a Swedish ajustable gastric band (SAGB) around the gastric pouch.
  
  
  RESULTS
  In previous reports, the gastric band was placed around the upper part of the stomach. This paper provides the first report of the placement of a gastric band around the lower gastric pouch, just above the gastrojejunal anastomosis, in the management of weight regain following laparoscopic RYGB. Prior to revision surgery, the patient's weight was 95 kg [body mass index (BMI) 31 kg/m(2), excess weight loss 65%].
  
  
  CONCLUSIONS
  Four months following the procedure this had reduced to 82.1 kg (BMI 26 kg/m(2), excess weight loss 90%).
authors.affiliation: North London Obesity Surgery Service, The Whittington Hospital, Magdala Avenue, London, N19 5NF, UK. dugal.heath@whittington.nhs.uk
authors.forename: Dugal
authors.initials: D
authors.lastname: Heath
authors.forename: Danile
authors.initials: D
authors.lastname: Leff
authors.forename: Pratik
authors.initials: P
authors.lastname: Sufi
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015390:Gastric Bypass / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000517:prevention & control / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome; D015430:Weight Gain