Q: What is normal phi angle?
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A: A normal gastric band should have a phi angle (angle between the spinal column and the gastric band) of 4°-58°
Q: What is the normal position of the lap band?
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A: In the anteroposterior (AP) projection, the band should be about 4–5 cm below the diaphragm, with a phi angle (angle between the spinal column and gastric band) of 4°-58°.
Q: What is the next confirmatory test of choice?
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A: Fluoroscopy is the initial study of choice in evaluating for gastric band slippage.
CT should be considered for evaluating cases in which abscess, perforation, or other complication is suspected.
Q: What is the importance of early diagnosis?
Name some of the complications of gastric lap banding?
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A: Early diagnosis and correction of gastric band slippage can prevent possible complications such as gastric perforation, gastric volvulus, and gastric necrosis.
Like any surgical procedure, gastric banding is associated with complications; the most common of which include band misplacement, band slippage, band herniation, perforation, pouch dilation, and erosion of the gastric wall. In band misplacement, the band may be placed around the lower part of the stomach.
Q: What is a radiologist's role here?
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A: Laparoscopic adjustable gastric banding has been growing in popularity since its introduction in 1993. Radiologists play a key role in evaluating the functionality and complications associated with gastric banding. The goal of gastric banding is to achieve early satiety by decreasing gastric volume.
This is accomplished by dividing the stomach into two portions with an adjustable silicone band. The stomach is divided into two portions: (1) a gastric pouch, which is the portion of the stomach proximal to the band and (2) the distal stomach beyond the site of banding.
The opening, or stoma, typically measures 3–4 mm. The band is connected to an access port catheter placed outside the peritoneal cavity, within the rectus abdominis muscle sheath or under the external thoracic fascia.
In the anteroposterior (AP) projection, the band should be about 4–5 cm below the diaphragm with a phi angle (angle between the spinal column and gastric band) of 4°-58°.
Q: How big is the stoma?
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A: The opening, or stoma, typically measures 3–4 mm.
Q: What kind of oral contrast should be used in fluoroscopy?
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A: Patients with perforation may present with fever, pain, and elevated white blood cell count. If perforation is suspected, water soluble contrast should be used to check for leakage.
Barium should be avoided as this may result in inflammation and fibrosis.
Q: What is the incidence of slippage?
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A: Gastric band slippage is a relatively common complication (4%–13%)