Initial experience with laparoscopic adjustable gastric banding and pouch dilatation: two cases

Background: Late proximal pouch dilatation (LPPD) has occurred occasionally following gastric banding for morbid obesity. At present, laparoscopic conservative resetting and oversuturing of the band is considered the standard procedure for pouch dilatation without any important posterior component. Methods: Two cases of LPPD are presented, which occurred in our initial experience with the Lap-Band®, corrected via a laparoscopic approach. Results: The reintervention was necessary in both patients, with conservative laparoscopic repositioning and oversuturing of the band in the first case and laparoscopic substitution of the gastric band in the second. We have not observed further complications, and weight loss has been maintained in a midterm outcome in both cases (30 and 18 months follow-up). Conclusions: LPPD can be corrected with a conservative laparoscopic surgical approach, without complications and negative functional effects on mid-term outcome.