title: Laparoscopic Treatment of a Large Gastric Pouch Following Gastric Band Slippage.
abstract: Gastric band slippage with formation of a gastric pouch is a frequent complication after gastric banding. There is no consensus on the treatment of this condition, which differs within and between centers. Here, we describe our treatment of a large gastric pouch after gastric band slippage. Despite removal of the band, the pouch caused oral feeding intolerance.
  
  
  
  The video shows our treatment of large gastric pouch following gastric banding and surgical revision. A 45-year-old woman with history of gastric banding was referred to our center for persistent oral feeding intolerance following gastric band removal.
  
  
  
  We found that a large gastric pouch was responsible for extrinsic compression and thus required revisional surgery after optimization of the patient's nutritional status. Video endoscopy revealed a large gastric pouch, which was responsible for oral feeding intolerance. Intra-operative exploration then revealed major adhesions, which had probably caused the pouch to form. During surgery that was somewhat analogous to sleeve gastrectomy, we removed the adhesions and resected the gastric pouch. The operating time was 70 min. An uneventful postoperative course enabled rapid discharge (on postoperative day 2).
  
  
  
  The formation of a large gastric pouch is a rare complication of chronic gastric band slippage. Following nutritional optimization, surgery is required.
authors.affiliation: Department of Digestive Surgery, Amiens University Hospital, Avenue René Laennec, 80054, Amiens cedex 01, France.
authors.forename: Baptiste
authors.initials: B
authors.lastname: Brac
authors.affiliation: Department of Digestive Surgery, Amiens University Hospital, Avenue René Laennec, 80054, Amiens cedex 01, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Rebibo
authors.affiliation: Department of Gastroenterology, Amiens University Hospital, Avenue René Laennec, 80054, Amiens cedex 01, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lemouel
authors.affiliation: Department of Digestive Surgery, Amiens University Hospital, Avenue René Laennec, 80054, Amiens cedex 01, France. regimbeau.jean-marc@chu-amiens.fr.|EA4294, Jules Verne University of Picardie, 80054, Amiens, France. regimbeau.jean-marc@chu-amiens.fr.|Clinical Research Center, Amiens University Hospital, Avenue René Laennec, 80054, Amiens cedex 01, France. regimbeau.jean-marc@chu-amiens.fr.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Regimbeau
mesh_terms: D002908:Chronic Disease; D020878:Device Removal; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D020250:Postoperative Nausea and Vomiting / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D013270:Stomach / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Band slippage; Gastric banding; Laparoscopy; Pouch dilatation