Department of Surgery, McGovern Medical School at UT Health, Houston, Texas, USA (all authors).
Michael E. Debakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, Texas, USA (Dr. Shah).

ABSTRACT

Introduction: Long-term outcomes of laparoscopic adjustable gastric band (LAGB) placement have shown suboptimal excess weight loss and higher than expected device-related complications.

Case Description: We report a 45-year-old woman in whom the adjustable gastric band tubing eroded into the stomach, causing a port-site infection.

Conclusion: Because of the number of LAGB procedures performed previously and the incidence of band-related complications, surgeons must be able to recognize and manage these complications. Erosion of the gastric band or the connection tubing or both should be included in the differential diagnosis for patients presenting with a port-site infection.

Key Words: Complications, Erosion, Gastric band.

The post Erosion of Gastric Band Tubing Presenting as Port-Site Cellulitis first appeared on JSLS.

Department of Surgery, University of Texas Medical School, Houston, TX (all authors). Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, TX (Dr Shah).

ABSTRACT

Introduction: With the decreasing popularity of adjustable gastric band (AGB) placement and the increase in explants of the devices, for erosion, slips, or inadequate weight loss, in performing revisional surgery, it is of vital importance for surgeons to understand the problems that may arise during removal. This case involved an uncommonly reported complication of fractured band tubing resulting in incomplete removal of the tubing during revisional bariatric surgery, with reoperation necessary for complete removal. In the course of the procedure, a small-bowel tumor was identified.

Case Description: We present a 35-year-old woman who underwent conversion of a laparoscopic AGB to a sleeve gastrectomy. Failure to recognize a fracture in the band tubing resulted in retained tubing and readmission secondary to abdominal pain. During reoperation to remove the retained tubing, a small-bowel gastrointestinal stromal tumor (GIST) was incidentally identified and resected.

Discussion: This case highlights a rarely reported complication of fractured gastric band tubing, resulting in incomplete removal of the tubing during revisional surgery, with the incidental discovery of a GIST in the small bowel.

Key Words: Adjustable gastric band, Gastrointestinal stromal tumor, Re-operative surgery, Revisional bariatric surgery.

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The post Words of Caution Regarding Adjustable Gastric Band Tubing first appeared on JSLS.

Department of Surgery, University of Texas Medical School at Houston, Houston, TX, USA (Drs. Starnes, Mehta, Shah, Bajwa, Wilson, Walker). Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, TX, USA (Dr. Shah).

ABSTRACT

Introduction: Complications due to retained gastric band tubing are rarely reported and frequently include disconnections of the tubing requiring operative revision. Obstruction from adjustable gastric band tubing is an infrequently reported event.

Case Description: The patient presented to us 1 month after removal of a presumed isolated infected port performed at an outside facility. The wound was left open, but the intra-abdominal tubing and band were left in place. Abdominal distention, pain, and peritonitis developed, and the patient was taken to the operating room because of concern regarding an acute intra-abdominal process. Intraoperatively, he was noted to have a sigmoid obstruction from the retained gastric band tubing.

Discussion: Although obstruction from adjustable gastric band tubing is infrequently reported in the literature, it poses a potentially devastating complication. We review the relevant literature and potential issues when dealing with band-related tubing.

Key Words: Internal hernia, Adjustable gastric band, Bowel obstruction, Port infection.

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The post Retained Gastric Band Tubing Resulting in Large Bowel Obstruction first appeared on JSLS.

Department of Surgery, University of Texas Medical School at Houston, Houston, Texas, USA (Drs. Ikoma and Shah); Keio University, School of Medicine, Tokyo, Japan (Drs. Ikoma, Itano, Oshima, and Kitagawa); Department of Surgery, Eiju General Hospital, Tokyo, Japan (Drs. Ikoma, Itano, and Oshima); Department of Surgery, Beth Israel Medical Center, New York, New York, USA (Dr. Fukuhara); Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, Texas, USA (Dr. Shah).

ABSTRACT

Hepatic malignancies are frequently associated with primary liver disease, including hepatitis and cirrhosis. It is not uncommon for selected patients to require repeated operations for tumor recurrence. Subsequent operations are more challenging because of dense adhesions from prior operations combined with the inherent risk for liver dysfunction. We present the case of a 64-year-old man with a 20-year history of hepatitis B who developed recurrent hepatocellular carcinoma and underwent repeated laparoscopic hepatectomies on 4 separate occasions. We found that the laparoscopic approach in repeat hepatectomy offers significant advantages, including minimal adhesions, superior visualization, and favorable effect by generated by pneumoperitoneum. Laparoscopic hepatectomy will potentially become a standard strategy for the treatment of liver malignancies associated with background liver abnormalities, which carry the high possibility of reemergence of the liver malignancy in the remnant of the liver.

Key Words: Laparoscopic surgery, Hepatectomy, HCC, Hepatitis.

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The post Laparoscopic Hepatectomy is Easier in Repeat Hepatectomy first appeared on JSLS.