Gastric band slippage

Last revised by Mostafa Elfeky on 9 Dec 2022

Gastric band slippage is a late complication of laparoscopic gastric banding surgery performed for obesity. It is reported to occur in 4-13% of cases 1-3.

It can occur in either an anterior or posterior direction.

Clinical presentation

Patients can present with cessation of weight loss, severe gastro-esophageal reflux, and nocturnal vomiting. If there is associated pouch dilation there may also by symptoms of obstruction.

Radiographic features

The diagnosis can be challenging as pouch slippage may occur transiently with progressive filling of the gastric stoma after which the band resumes a normal position.

Plain radiograph
  • the 'O' sign is seen on AP views which represents the gastric band being visible end on. This is highly suggestive of posterior band slippage 4

  • Phi angle: the angle between the vertical axis and gastric band in AP view 6

    • angle of 45° indicates good position

    • angle greater than 58° indicates slipped band


This shows abnormal band position as well as a stoma cavity with a maximal diameter exceeding 4 cm representing associated pouch dilation.


This demonstrates herniation of the stomach through the gastric band. It may also demonstrate eccentric pouch dilation.

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