Laparoscopic adjustable gastric banding.

BACKGROUND: The laparoscopic adjustable gastric band is a useful tool in the treatment of severe obesity. It is a safe and durably effective procedure, however, optimal results depend upon the patient participating in a process of lifelong care.
OBJECTIVE: This article discusses the procedure, follow up, and late complications for laparoscopic adjustable gastric banding. It also provides the general practitioner with 'alert' symptoms and signs of when to contact the treating surgeon. DISCUSSION: Lifelong care involves counselling about food choices and eating patterns, as well as adjustment of the device. The delivery of this care usually involves a multidisciplinary team. Patients should not be offered surgery unless a process for continuing care is in place. Late complications of laparoscopic adjustable gastric banding are relatively common; however, they can be readily treated in most cases, with weight loss continuing. Symptoms of volume reflux, nocturnal aspiration, dysphagia, regular regurgitation and vomiting may alert the primary care GP to complications. Abdominal pain along with any of these symptoms may suggest an acute complication, but other causes of abdominal pain should also be considered, depending on the clinical scenario.