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Dr. Rami E Lutfi, MD, FACS performs laparoscopic placement of a LapBand over a failed open gastric bypass performed 10 years prior. Laparoscopic entry, lysis of adhesions, and hiatal dissection with the discovery and repair of a hiatal hernia are illustrated. Gastric pouch is defined, and the band placed high, well above the gastro-esophageal junction to avoid the need to "wrap it" with the gastric remnant as it was severely adherent to the spleen

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