Introduction: Laparoscopic adjustable gastric banding (LAGB) is a commonly performed bariatric procedure, but a consensus has not been reached about what to do when LAGB fails. The experience of patients who underwent laparoscopic sleeve gastrectomy (LSG) after failed LAGB is reported.

Methods: In our video, we reported a 56-year-old male with a BMI of 52 who underwent laparoscopic gastric banding three years earlier. He had an uneventful initial surgery and lost 39% excess weight loss at one year after fully adjusting his band. We performed an upper GI and a test for leak of the band and both tests were negative.

Results: Despite several adjustments and diet restriction, he gained 90 lbs and started again developing high blood pressure and diabetes, which was a problem prior to the operation. He was taken to the operating room and he had his band removed by the laparoscopic technique and sleeve gastrectomy with reinforced staple line. He was discharged home in 48 hours and the drainage was removed after ten days. He lost 85 lbs in nine months and his blood pressure and diabetes resolved.

Conclusion: Based on our initial experience, LSG is a feasible and safe operation for patients who have failed LAGB.