Alternative technique for creation of a proximal gastric pouch in laparoscopic adjustable silicone gastric banding

Background: Laparoscopic adjustable silicone gastric banding (LASGB) has become a widely used procedure for the treatment of morbid obesity. The original operation, as described by Kuzmak, has been subjected to modifications. Construction of a proximal gastric pouch is an important part of the operation. Until now, we used the technique of Niville. Since this was often complicated by gastric bleeding and/or serosal tears, we developed a new technique to construct a pouch. Surgical Technique: A new technique, using a thread previously fixed to that portion of the fundus that will be used to construct the pouch, is described. Conclusion: A safe and easy adaptation of the LASGB technique is proposed to create the gastric pouch.