Lap band complications - Revision history

Danbot: Add verified PubMed references (PMIDs 15018757)

2026-03-22T10:56:56Z

Add verified PubMed references (PMIDs 15018757)

← Older revision		Revision as of 10:56, 22 March 2026
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	==Background==		==Background==

	*Laparoscopic adjustable gastric banding		*Laparoscopic adjustable gastric banding <ref>Fried M, Miller K, Kormanova K. Literature review of comparative studies of complications with Swedish band and Lap-Band. Obes Surg. 2004 Feb;14(2):256-60. PMID 15018757</ref>
	*Band placed at gastroesophageal junction and inflated to limit food passage		*Band placed at gastroesophageal junction and inflated to limit food passage
	*Band constriction adjustable via reservoir		*Band constriction adjustable via reservoir

Danbot: Add evidence-based Disposition section

2026-03-22T10:03:24Z

Add evidence-based Disposition section

← Older revision		Revision as of 10:03, 22 March 2026
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	*Consider deflating band via port site if impending gastric necrosis due to edema/recent band inflation		*Consider deflating band via port site if impending gastric necrosis due to edema/recent band inflation


			==Disposition==
			*Admit for:
			**Band slippage with obstruction or inability to tolerate liquids
			**Band erosion (requires surgical removal)
			**Peritonitis or signs of perforation
			**Severe dehydration from prolonged vomiting
			*Discharge with surgical follow-up for:
			**Mild port-site complications
			**Resolved obstructive symptoms after band adjustment
			**Mild reflux symptoms

	==See Also==		==See Also==

Ostermayer: Prepared the page for translation

2026-01-04T23:16:26Z

Prepared the page for translation

← Older revision		Revision as of 23:16, 4 January 2026
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			<languages/>
			<translate>

	==Background==		==Background==

	*Laparoscopic adjustable gastric banding		*Laparoscopic adjustable gastric banding
	*Band placed at gastroesophageal junction and inflated to limit food passage		*Band placed at gastroesophageal junction and inflated to limit food passage
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	*Postoperative complications near 10% over lifetime of patient		*Postoperative complications near 10% over lifetime of patient
	*Patients typically discharged same day or POD #1		*Patients typically discharged same day or POD #1


	==Clinical Features==		==Clinical Features==
	*[[abdominal pain\|Abdominal]], [[chest pain\|chest]] or [[neck pain\|neck]]/[[sore throat\|throat pain]]
	*[[Nausea/vomiting]], food intolerance		*[[Special:MyLanguage/abdominal pain\|Abdominal]], [[Special:MyLanguage/chest pain\|chest]] or [[Special:MyLanguage/neck pain\|neck]]/[[Special:MyLanguage/sore throat\|throat pain]]
	*[[Sepsis]], abnormal vitals		*[[Special:MyLanguage/Nausea/vomiting\|Nausea/vomiting]], food intolerance
			*[[Special:MyLanguage/Sepsis\|Sepsis]], abnormal vitals


	==Differential Diagnosis==		==Differential Diagnosis==


	===Early===		===Early===

	''At or near time of banding or adjustment of band''		''At or near time of banding or adjustment of band''
	*Acute gastroesophageal obstruction - postop edema at application site forces proximal movement of the band, get KUB		*Acute gastroesophageal obstruction - postop edema at application site forces proximal movement of the band, get KUB
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	*Perforated viscus		*Perforated viscus
	**Esophageal pouch dilation – pain, vomiting, nausea		**Esophageal pouch dilation – pain, vomiting, nausea


	===Late===		===Late===

	''Weeks to years after adjustment or application''		''Weeks to years after adjustment or application''
	*Chronic Slippage		*Chronic Slippage
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	*Tubing Dislodgement		*Tubing Dislodgement
	*Port Ulceration		*Port Ulceration


	==Evaluation==		==Evaluation==

	*Lab workup dictated by presentation		*Lab workup dictated by presentation
	*Obtain an upright [[KUB]] to assess band position & slippage		*Obtain an upright [[Special:MyLanguage/KUB\|KUB]] to assess band position & slippage
	**Phi (φ) angle- Angle between a vertical line oriented through the spine and a second line running on the long axis of the lap band		**Phi (φ) angle- Angle between a vertical line oriented through the spine and a second line running on the long axis of the lap band
	**Normal is 4-58 degrees		**Normal is 4-58 degrees
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	*CT Abd/Pelvis to assess for perforation (contained or free), abscess, intra-abdominal fluid or bleeding		*CT Abd/Pelvis to assess for perforation (contained or free), abscess, intra-abdominal fluid or bleeding
	*Endoscopy – visualize inner lumen of esophagus and stomach for partial or full erosion		*Endoscopy – visualize inner lumen of esophagus and stomach for partial or full erosion


	==Management==		==Management==

	*Early surgical consultation key for all patients suspected of having complications		*Early surgical consultation key for all patients suspected of having complications
	*Intra-abdominal [[sepsis]] management (fluids, antibiotics)		*Intra-abdominal [[Special:MyLanguage/sepsis\|sepsis]] management (fluids, antibiotics)
	*Remember to dose [[Antibiotic\|antibiotics]] for morbid obesity if necessary		*Remember to dose [[Special:MyLanguage/Antibiotic\|antibiotics]] for morbid obesity if necessary
	*Consider deflating band via port site if impending gastric necrosis due to edema/recent band inflation		*Consider deflating band via port site if impending gastric necrosis due to edema/recent band inflation


	==See Also==		==See Also==
	*[[Bariatric surgery complications]]
	*[[Medical device complications]]		*[[Special:MyLanguage/Bariatric surgery complications\|Bariatric surgery complications]]
			*[[Special:MyLanguage/Medical device complications\|Medical device complications]]


	==References==		==References==

	<references/>		<references/>

	[[Category:GI]]		[[Category:GI]]
	[[Category:Surgery]]		[[Category:Surgery]]
			</translate>

Masoodrm: /* Evaluation */

2022-04-24T15:15:57Z

Evaluation

← Older revision		Revision as of 15:15, 24 April 2022
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	==Evaluation==		==Evaluation==
	*Lab workup dictated by presentation		*Lab workup dictated by presentation
	*[[KUB]]~~-upright~~ to assess band position & slippage		*Obtain an upright [[KUB]] to assess band position & slippage
	**~~normal: 30~~-~~45 deg to~~ the ~~horizontal (~2 o'clock)~~		**Phi (φ) angle- Angle between a vertical line oriented through the spine and a second line running on the long axis of the lap band
			**Normal is 4-58 degrees
	*Swallow Study under fluoroscopy to assess for gastro-esophageal obstruction		*Swallow Study under fluoroscopy to assess for gastro-esophageal obstruction
	*CT Abd/Pelvis to assess for perforation (contained or free), abscess, intra-abdominal fluid or bleeding		*CT Abd/Pelvis to assess for perforation (contained or free), abscess, intra-abdominal fluid or bleeding

ClaireLewis at 22:51, 29 September 2019

2019-09-29T22:51:46Z

← Older revision		Revision as of 22:51, 29 September 2019
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	==Clinical Features==		==Clinical Features==
	*Abdominal, chest or neck/throat pain		*[[abdominal pain\|Abdominal]], [[chest pain\|chest]] or [[neck pain\|neck]]/[[sore throat\|throat pain]]
	*Nausea, vomiting, food intolerance		*[[Nausea/vomiting]], food intolerance
	*Sepsis, abnormal vitals		*[[Sepsis]], abnormal vitals

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	*Lab workup dictated by presentation		*Lab workup dictated by presentation
	*KUB-upright to assess band position & slippage		*[[KUB]]-upright to assess band position & slippage
	**normal: 30-45 deg to the horizontal (~2 o'clock)		**normal: 30-45 deg to the horizontal (~2 o'clock)
	*Swallow Study under fluoroscopy to assess for gastro-esophageal obstruction		*Swallow Study under fluoroscopy to assess for gastro-esophageal obstruction

Mholtz at 23:50, 30 May 2017

2017-05-30T23:50:21Z

← Older revision		Revision as of 23:50, 30 May 2017
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	*Intra-abdominal [[sepsis]] management (fluids, antibiotics)		*Intra-abdominal [[sepsis]] management (fluids, antibiotics)
	*Remember to dose [[Antibiotic\|antibiotics]] for morbid obesity if necessary		*Remember to dose [[Antibiotic\|antibiotics]] for morbid obesity if necessary
	*If impending gastric necrosis due to edema/recent band inflation		*Consider deflating band via port site if impending gastric necrosis due to edema/recent band inflation
	*Can deflate band via port site, otherwise wait for surgeon

	==See Also==		==See Also==
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	==References==		==References==
	*Ann Emerg Med 2006;47:160-6		<references/>

	[[Category:GI]]		[[Category:GI]]
	[[Category:Surgery]]		[[Category:Surgery]]

Alvarez13 at 23:49, 21 November 2016

2016-11-21T23:49:32Z

← Older revision		Revision as of 23:49, 21 November 2016
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	==Management==		==Management==
	*~~early~~ surgical consultation key for all patients suspected of having complications		*Early surgical consultation key for all patients suspected of having complications
	*~~intra~~-abdominal [[sepsis]] management (fluids, antibiotics)		*Intra-abdominal [[sepsis]] management (fluids, antibiotics)
	*~~remember~~ to dose antibiotics for morbid obesity if ~~neccesary~~		*Remember to dose [[Antibiotic\|antibiotics]] for morbid obesity if necessary
	*if impending gastric necrosis due to edema/recent band inflation		*If impending gastric necrosis due to edema/recent band inflation
	*Can deflate band via port site, otherwise wait for surgeon		*Can deflate band via port site, otherwise wait for surgeon

Alvarez13 at 23:48, 21 November 2016

2016-11-21T23:48:41Z

← Older revision		Revision as of 23:48, 21 November 2016
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	==Clinical Features==		==Clinical Features==
	*~~abdominal~~, chest or neck/throat pain		*Abdominal, chest or neck/throat pain
	*~~nausea~~, vomiting, food intolerance		*Nausea, vomiting, food intolerance
	*~~sepsis~~, ~~abdnormal~~ vitals		*Sepsis, abnormal vitals

	==Differential Diagnosis==		==Differential Diagnosis==

Alvarez13 at 23:47, 21 November 2016

2016-11-21T23:47:49Z

← Older revision		Revision as of 23:47, 21 November 2016
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	==Background==		==Background==
	*~~laparoscopic~~ adjustable gastric banding		*Laparoscopic adjustable gastric banding
	*~~band~~ placed at gastroesophageal junction and inflated to limit food passage		*Band placed at gastroesophageal junction and inflated to limit food passage
	*~~band~~ constriction adjustable via reservoir		*Band constriction adjustable via reservoir
	*~~subcutaneous~~ reservoir (~5ml port site) allows adjustment without invasive intervention		*Subcutaneous reservoir (~5ml port site) allows adjustment without invasive intervention
	*~~postoperative~~ complications near 10% over lifetime of patient		*Postoperative complications near 10% over lifetime of patient
	*~~patients~~ typically discharged same day or POD #1		*Patients typically discharged same day or POD #1

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: Text replacement - "abd " to "abdominal "

2016-07-31T13:37:10Z

Text replacement - "abd " to "abdominal "

← Older revision		Revision as of 13:37, 31 July 2016
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	*Port Complications		*Port Complications
	**primary overlying skin infection may represent extension of intra-abdominal process		**primary overlying skin infection may represent extension of intra-abdominal process
	**need antibiotic coverage for intra-~~abd~~ and skin flora		**need antibiotic coverage for intra-abdominal and skin flora
	*Tubing Dislodgement		*Tubing Dislodgement
	*Port Ulceration		*Port Ulceration