We perform a sleeve gastrectomy, on a female 56 year old, who already have a LAPBAND 2005, with minimal weight lost.

Under general anesthesia (IV medication: Remifentanil-Ultiva® plus Propofol Diprivan® previous asepsia with Duraprep® and insufflation with CO₂ of abdominal cavity, access thought 5 trocars. First release some adhesions from liver to anterior stomach, identify Lap Band, dissection and open its tunnel (fundic wrap), until Hiss angle and left crura; after we dissect and remove out prosthesis material; we continue to dissect the capsule or fibrous ring over anterior stomach wall. After we identify pylorus and measure 5 cm and was marked; then, we began to dissect, the major curvature from gastro-colic epiplon, and release fundus from short vessels with Harmonic Scalpel (Ethicon®), until Hiss angle and left crura, at this time Lap Band was removed. Then the stomach was stapled and divided (ENDOGIA 3.5 and 4.8 mm staples by Tyco®), beginning 5 cm above pylorus using a Nelaton tube No. 36 as a tutor; until release of fundus. The staple line was invaginated with continuous row seromuscular - seromuscular stitches (Ticron 2-0®)

The Evolution was good, she loose 15 lbs on the first 2 weeks, the quality of life improves.

The sleeve gastrectomy its another option to convert the gastric banding with good outcome, after 2 weeks of the surgery she lost 22% of the EBW.