Retained Foreign Body After Adjustable Gastric Band Removal:
a Case Series
Published online: 10 October 2017
Springer Science+Business Media, LLC 2017
Abstract Laparoscopic adjustable gastric band (LAGB)
has weight loss and associated obesity-related disease
benefits. Well-recognised LABG complications lead to a
higher re-operation rate when compared to other obesity
surgeries and therefore potential for retained foreign body.
By way of a case series, we have evaluated retained for-
eign body after the intended complete removal of a gastric
band. Analysis focused on circumstances and similarities
leading to retained foreign body. From the series, the most
commonly retained band component is band tubing.
Difficult surgery or surgery associated with intra-
operative complications may lead to increased chances
of retained gastric band. Strategies to prevent this compli-
cation should be implemented. Specifically, removal tech-
nique, equipment familiarisation and post removal inspec-
tion all play a role.
Keywords Gastric band complication
Adjustable gastric band
Surgical foreign body
Removal of gastric band
Revision obesity surgery
Evidence for laparoscopic adjustable gastric band (LAGB)
demonstrates significant weight loss and associated reductions
in obesity-related co-morbidities [1, 2]. LAGB surgery has a
low operative mortality rate and peri-operative complication
rate; however, it is associated with a higher re-operation rate
compared with other bariatric operations . Re-operations
after banding include band removal for proximal enlargement,
slippage or erosion and port revisions for band leaks .
Procedures performed to remove gastric band devices can
themselves be subject to complications including retained sur-
gical items. In Australia, there were over 3500 reversal of
bariatric procedures for the 12 months ending December
2014 . Given the high number of LAGB performed in
Australia since the late 1990s, it is reasonable to assume a
significant proportion of these procedures involved the re-
moval of gastric bands.
The incidence of retained foreign body following surgery is
rare in the literature with estimates ranging from 1 in 5500 to 1
in 18,760 operations . The abdominal cavity is one of the
most common sites of retained surgical items . Risk factors
identified for retained surgical items include emergency sur-
gery, unplanned change in operation and higher average
body mass index . Obesity surgery is generally per-
Retained gastric band components can potentially contrib-
ute to this higher litigation risk.
We present three cases of retained foreign body complicating
the removal of gastric band devices.
* Daniel Cattanach
Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
Griffith University, Gold Coast, Australia
Ashford Hospital, Ashford, South Australia, Australia
OBES SURG (2017) 27:3337–3340