Intraluminal penetration of the band in patients with adjustable silicone gastric banding: radiological findings

Laparoscopic gastric band migration: role of environmental factors in the experience of a single team in three operating rooms

Stomach erosion after gastric banding represents one of its least studied complications, despite the fact that the modalities of presentation and treatment have been clarified in recent years. Associations between this complication and specific surgical factors related to the patient have not been reported. We evaluated the incidence of this complication in various operating environments, to identify a possible association with a specific risk factor. A total of 250 patients underwent gastric banding between 2006 and 2008 and were followed for at least 1 year of follow-up. The procedure was performed in three Centers by the same surgical team. Center A was selected for the learning curve, in the initial phase of the study. All surgeries were performed with standardized techniques. An annual endoscopic evaluation was performed during first 12 months. The data from the three Centers were evaluated comparatively, to assess the incidence of migration and compare sterilization and perioperative preparation techniques. Between May 2006 and December 2008, 140 patients operated on at Center A, 70 at Center B, and 50 at Center C were included. Twelve cases of intragastric migration were observed (4.8% of the entire cohort): two cases at Center A (1.4%) and 10 cases at Center C (25%; A vs. C and A vs. B, p < 0.05); no cases of erosions were observed in Center B of 50 patients (0%; reviewer 1, comment 1). From a retrospective observation, no significant difference in sterilization techniques was observed, while there were differences in perioperative preparation, although these are not objectifiable parameters.

Radiological imaging of the GI tract after bariatric surgery

BACKGROUND

Obesity is becoming epidemic in proportion and is leading to considerable morbidity and mortality in the community. Bariatric surgery offers one tested solution to sustained weight loss and comorbidity reduction. However, it is associated with a significant number of complications.

OBJECTIVE

The objective of this article is to review the utility of radiological techniques in the diagnosis of surgical complications after bariatric surgery.

DESIGN

Literature-based review and pictorial illustration in the use of imaging techniques in the diagnosis of complications after bariatric surgery.

CONCLUSIONS

Radiology plays a critical role in the diagnosis of complications after bariatric surgery. Upper GI contrast study and CT are the most commonly used imaging modalities in this regard. They are complementary in their diagnostic abilities and should be used in concert for the complete evaluation of symptomatic patients. All other radiological imaging modalities are also used in the diagnosis of complications after bariatric surgery, but much less commonly.

Delayed Hyperenhancement by Contrast-Enhanced Magnetic Resonance Imaging

The clinical applications of contrast-enhanced magnetic resonance (MR) imaging for defining viability are evolving as a result of the advantage of the technique's excellent spatial resolution. The value of delayed hyperenhancement imaging is for the accurate identification of the infarcted myocardium with resolution that allows determination of the transmural extent of myocardial injury. In addition, nonischemic patterns of myocardial injury such as dilated or hypertrophic cardiomyopathy have been reported in other disease states. Delayed hyperenhancement may have an additional role in guiding the management of or determining the prognosis for diseases such as myocarditis. In this study, the clinical application of delayed hyperenhancement is demonstrated for various cardiac diseases such as myocardial infarction, including right ventricular infarction; microvascular obstruction; and nonischemic cardiomyopathy such as dilated cardiomyopathy and myocarditis.

Complications of Adjustable Gastric Banding, a Radiological Pictorial Review

OBJECTIVE

The purpose of this article is to review the radiologic appearance of complications of the adjustable gastric band.

CONCLUSION

Continuous progress in surgical technique of adjustable gastric banding and the increasing experience of surgeons have decreased the rate of complications. However, because different complications may have the same clinical presentation but require different treatment, to give a definitive diagnosis, the radiologist must be aware of the surgical procedures and possible sequelae.

Technical Controversies in Fundoplication Surgery

Gastroesophageal reflux disease (GERD) is a common health problem affecting more than 50% of the population. For those who experience more than occasional symptoms, GERD has a profound effect on their quality of life. With the advent of laparoscopic surgery, fundoplication has been used to treat GERD. Fundoplication also is used in the surgical management of paraesophageal hernias. Technical controversies are addressed in this article, including open versus laparoscopic approaches, the choice of complete (360 degres) or partial fundoplication, whether or not a gastroplasty is required, and the use of prosthetic materials in crural repair.

Technical aspects and complications of laparoscopic banding for morbid obesity—a radiological perspective

Morbid obesity is a significant clinical problem in the western world. Various surgical restrictive procedures have been described as an aid to weight reduction when conservative treatments fail. Adjustable laparoscopic gastric banding (LAPBAND) has been popularized as an effective, safe, minimally invasive, yet reversible technique for the treatment of morbid obesity. Radiological input is necessary in the follow-up of these patients and the diagnosis of complications peculiar to this type of surgery. In this review we will highlight the technical aspects of radiological follow-up and the lessons learnt over the last 5 years.