The pars flaccida technique of LAP-BAND surgery is commonly used to treat obesity.
LAP-BAND surgery is becoming a popular alternative to gastric bypass and other invasive techniques for weight loss. The most common LAP-BAND procedure is called the pars flaccida technique, which is so named because the initial incision is made at the pars flaccida area of the omentum. A band is placed around the entrance to the stomach and a balloon is used to tighten and lessen the amount of food the stomach can hold.
Instructions
1. Position the patient. The patient lies on his back with his legs spread. The doctor stands between the legs with the surgical team surrounding him. Six trocars, sharply pointed hollow shafts ending in three-sided points are inserted into the stomach area to help with placement of the LAP-BAND system.
2. Begin initial incisions. A balloon is inserted into the stomach and inflated using saline, which creates a bulge in the stomach and allows the surgeon to determine where to make the initial incision. An incision is made near the lesser curvature of the stomach most commonly near the pars flaccida of the omentum. The lesser curvature of the stomach is exposed and an incision is made as close as possible to the gastric wall and large enough to fit the gastric band.
3. Continue secondary incisions. A second window is created near the gastric fundus between the spleen and the esophagous. An Endograsp Roticulator is introduced through an upper trocar and placed in the retrogastric tunnel. The instrument's coagulating hook grasps the diaphragm.
4. Introduce the LAP-BAND. Using another of the upper trocars, the LAP-BAND is introduced and using the Roticulator, placed around the stomach at the level of the initial incisions. The tubing is looped around the stomach until it reaches the locking area of the band. A special tool is then used to tighten the band around the stomach and locked into position. The band is then calibrated to a specific width using an attached balloon that is filled with saline.
5. Create an access port. The ports of the LAP-BAND are removed and the tube is connected to the injection reservoir. The reservoir is sutured to the wall of the stomach. Post-surgery, the LAP-BAND can be adjusted using this tube, which negates the need for more invasive surgery for adjustments.
Tags: pars flaccida, around stomach, incision made, curvature stomach, flaccida technique, initial incision, initial incisions