title: Internal hernia due to adjustable gastric band tubing: review of the literature and illustrative case video.
abstract: BACKGROUND
  Laparoscopic adjustable gastric banding (LAGB) is a commonly performed bariatric procedure. Device-related morbidity is typically associated with the subcutaneous port or the band itself. Complications related to band tubing are unusual. Small bowel obstruction (SBO) after LAGB is a unique and serious complication; there is the potential of delayed diagnosis and the risk of closed-loop bowel obstruction. SBO secondary to internal hernia caused by band tubing is very rare, with only five cases reported in the literature.
  
  
  METHODS
  In this article, we describe our experience and provide an illustrative video of a case of SBO related to band tubing. We also provide a detailed review of the few previously published case reports.
  
  
  RESULTS
  Based on the common features of our case and other published case reports, we hypothesize some risk factors that might lead to this unique morbidity of adjustable gastric band tubing and provide potential solutions to prevent this problem.
  
  
  CONCLUSIONS
  Tubing-related SBO is a serious complication with the risk of closed-loop bowel obstruction. Urgent operative exploration is required to avoid bowel strangulation. To prevent recurrence we advise functionally shortening the tubing by tucking it to the right upper quadrant above the liver and also provide some omental coverage between the bowel and band tubing if possible.
authors.affiliation: Department of Surgery, King Hussein Cancer Center, 202 Queen Rania Alabdullah Street, P.O. Box 1269, Amman, 11942, Jordan, hamed.h.osama@gmail.com.
authors.forename: Osama H
authors.initials: OH
authors.lastname: Hamed
authors.forename: Lashondria
authors.initials: L
authors.lastname: Simpson
authors.forename: Emanuele
authors.initials: E
authors.lastname: Lomenzo
authors.forename: Mark D
authors.initials: MD
authors.lastname: Kligman
mesh_terms: D000328:Adult; D000368:Aged; D004868:Equipment Failure; D019544:Equipment Failure Analysis; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D046449:Hernia, Abdominal / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012307:Risk Factors