Gastric Stenosis Four Years After Adjustable Gastric Band Removal Surgery-A Video Case Report.

Abstract

Laparoscopic adjustable gastric banding (LAGB) is a type of bariatric surgery. Gastric stenosis or obstruction is a known complication of LAGB; however, its occurrence after band removal is extremely rare. A 60-year-old female, who had undergone LAGB 6 years earlier and band removal 4 years prior, presented to the hospital with recurrent vomiting. Abdominal computed tomography revealed gastric stenosis with proximal gastric distension and endoscopy showed deformation of the gastric mid-body with luminal narrowing. Surgical intervention for adhesiolysis was planned, and intraoperatively, severe fibrotic adhesions encircling the mid-body of the stomach were identified. Dissection of the greater omentum near the transverse colon was performed first to expose the posterior wall of the stomach. Adhesions between the posterior wall of the stomach and the supra-pancreatic area tissues near the left gastric artery and splenic artery were meticulously dissected. Subsequently, the adhesions between the anterior wall of the stomach and the tissues along the left gastroepiploic artery were dissected. Postoperative computed tomography and endoscopy revealed a restored normal anatomical structure of the stomach. Adhesion-induced gastric stenosis should be considered as a differential diagnosis even years after the removal of a gastric band, warranting timely adhesiolysis when necessary.