Introduction: One of the most common complications after adjustable gastric banding is band slippage. This video shows the laparoscopic technique for reduction and repositioning of band slippage in a patient who presents with severe reflux and obstructive symptoms four years after band placement. Her BMI at presentation was 29.

Methods: Using five abdominal ports, adhesiolysis was performed to expose the liver and the gastric band. The previous gastro-gastric suture line was divided using a laparoscopic stapler and ultrasonic shear. After unsuccessful attempts at reducing the slippage with the band in place, the band was unbuckled, the anterior gastric slippage was reduced and the band was repositioned high on the stomach. Anterior gastro-gastric sutures were replaced.

Results: The operative time was 60 minutes. There were no postoperative complications and the length of hospital stay was 2 days. The patient continues to do well and has not experienced weight regain at 1 year following reoperation.

Conclusion: Laparoscopic reduction and repositioning of gastric band slippage is technically feasible and can lead to maintenance of weight loss. This video shows some important fundamentals of revisional surgery.