Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components
CPT4 code
Name of the Procedure:
Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components.
Common names: Lap-Band removal, Adjustable Gastric Band removal.
Summary
This procedure involves the surgical removal of an adjustable gastric band and its associated subcutaneous port. The gastric band assists with weight loss by limiting food intake, and its removal is typically performed laparoscopically using small incisions and specialized instruments.
Purpose
The procedure addresses issues related to the adjustable gastric band, such as band slippage, erosion, infection, or inefficacy in achieving weight loss goals.
Indications
- Complications from the gastric band, such as slippage, erosion, or infection
- Failure to achieve adequate weight loss or resolution of comorbid conditions
- Persistent adverse symptoms like nausea, vomiting, or pain
Preparation
- Patients may need to fast for a specified period before the surgery.
- Adjustments to current medications, especially blood thinners.
- Preoperative assessments including blood tests, imaging, and consultation with the surgical team.
Procedure Description
The surgery is performed under general anesthesia. Small incisions are made in the abdomen to insert a laparoscope (a camera) and surgical instruments.
- The surgeon locates the gastric band and port.
- The tubing connecting the band to the port is cut.
- The band is carefully removed from around the stomach.
- The subcutaneous port is detached and removed.
- Incisions are closed with sutures or surgical glue.
Duration
The procedure generally takes between 1 to 2 hours.
Setting
Typically performed in a hospital or surgical center where laparoscopic procedures are conducted.
Personnel
- General surgeon with expertise in bariatric surgery
- Anesthesiologist
- Surgical nurses
- Surgical technician
Risks and Complications
- Infection at the surgical site
- Bleeding
- Injury to adjacent organs like the stomach or liver
- Blood clots
- Adverse reactions to anesthesia
- Delayed gastric emptying or changes in digestion
Benefits
- Relief from complications or adverse symptoms related to the gastric band
- Improved quality of life
- Potential for better weight management with alternative methods
Recovery
- Post-operative monitoring in a recovery room
- Pain management with prescribed medications
- Gradual reintroduction of diet, starting with liquid and soft foods
- Avoid heavy lifting and strenuous activities for several weeks
- Follow-up appointments to monitor healing and discuss further weight management strategies
Alternatives
- Revisional bariatric surgery (e.g., conversion to gastric bypass or sleeve gastrectomy)
- Non-surgical weight loss interventions (e.g., diet, exercise, medication)
- Thorough consideration of the risks, benefits, and efficacy of each alternative
Patient Experience
- Patients may experience mild to moderate postoperative pain, managed with medications.
- Initial discomfort at incision sites.
- Gradual improvement in symptoms related to the gastric band.
- Support from healthcare providers in transitioning to new weight management strategies.