An unusual cause of gastric pouch outlet obstruction as a late complication of banded gastric bypass

– see /10.10 ence: I Surg LL1 _bowl Although still relatively uncommon, an increasing number of revisional bariatric surgical procedures are being carried out for weight regain or technical failure of the primary operation [1]. A range of revisional procedures has been developed, but one such option is the use of an adjustable gastric band positioned around a dilated gastric pouch after the index procedure of Roux-en-Y gastric bypass (RYGB), which has been previously been described as salvage gastric banding [2]. It is widely acknowledged that revisional bariatric surgery is associated with increased rates of morbidity and mortality [3], but most studies are concerned with problems encountered in the immediate postoperative period. We present a case of gastric pouch outlet obstruction through a hitherto undescribed mechanism in a female patient who had undergone salvage gastric banding 4 years previously, 3 years after her index laparoscopic gastric bypass. (Surg Obes Relat Dis 2013;9;e41– e42.) r 2013 American Society for Metabolic and Bariatric Surgery. All rights reserved.