ADJUSTABLE LAPAROSCOPIC GASTRIC BAND FOR THE TREATMENT OF MORBID-OBESITY - RADIOLOGIC EVALUATION

OBJECTIVE. This article describes the radiographic appearance of a rec ently developed laparoscopically placed adjustable gastric band for th e treatment of morbid obesity. The optimal technique for contrast eval uation of the device, complications associated with its use, and the t echnique for stoma adjustments are also discussed. SUBJECTS AND METHOD S. Between May and December 1996, 23 patients at our institution under went laparoscopic placement of adjustable silicone gastric bands for t reatment of morbid obesity. All patients underwent a barium upper gast rointestinal series before surgery, 1 day after band placement, at var iable intervals when each patient returned for band adjustment, and at 1 year. RESULTS. Unlike the case in other gastric weight loss procedu res, the optimal patient position for contrast evaluation of gastric b ands was anteroposterior or slightly right posterior oblique. Twenty-o ne of 23 patients had no complications shown on the postoperative uppe r gastrointestinal series, Stoma size was approximately 3-8 mm, and mo st patients showed delayed esophageal emptying without obstruction. Tw o patients had herniation of the stomach through the gastric band with pouch enlargement, resulting in obstruction and the need for addition al surgery. We saw no leaks or band erosions, Nineteen stoma adjustmen ts were performed in 13 patients. One patient had an inverted port tha t could not be accessed for adjustment. CONCLUSION. As adjustable gast ric bands become more widely used, radiologists need to be familiar wi th the radiographic appearance of the devices, the complications assoc iated with their use, and the optimal patient positioning for contrast evaluation, Radiologists may also be involved with band adjustment to decrease or increase the stoma size and therefore need to understand the technique and potential difficulties of adjusting the stoma.