Laparoscopic Gastric Band Placement in Combination With Sleeve Gastrectomy for Advanced Weight Loss: A Case Report.

Laparoscopic adjustable gastric banding (LAGB) over laparoscopic sleeve gastrectomy (LSG) is a rare bariatric surgery. The objective of this case report is to add to the limited literature regarding this procedure. LAGB plus LSG is an effective bariatric procedure for patients that desire additional weight loss who do not qualify for or want gastric bypass. A 39-year-old African American Female with a pertinent past medical history of morbid obesity, gastroesophageal reflux disease (GERD), sleep apnea, and chronic back pain presents for gastric bypass consultation in 2020. The patient had a prior bariatric surgical history of gastric band placement (2014), removal (2016), and LSG (2018). The patient was unsatisfied with her weight loss and pursued a consultation for gastric bypass. Upon further investigation, gastric bypass was not indicated for the patient due to low BMI. The patient was presented with the option of LAGB over LSG for increased weight loss and improvement or resolution of comorbid conditions. The patient appreciated the physicians' recommendation, and on June 3, 2021, a LAGB was placed over the prior sleeve gastrectomy. No complications occurred preoperatively or postoperatively. The patient continues to adhere to diet and exercise instructions, and at her most recent follow-up, she reported resolution of GERD symptoms and had a reduced BMI of 33.2. It is important to note that the long-term outcomes of this procedure are yet to be fully discovered due to the rarity of the surgery and some literature deficiencies. Overall, LAGB, in combination with LSG, is a safe and effective procedure for increasing weight loss, improving quality of life, and decreasing mortality for patients for whom the surgery is indicated.