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Surgical Endoscopy

Published in:

01-08-2011

Laparoscopic sleeve gastrectomy as a revisional option after gastric band failure

Authors: David Goitein, Anya Feigin, Gabriella Segal-Lieberman, Orly Goitein, Moshe Zvi Papa, Dov Zippel

Published in: Surgical Endoscopy | Issue 8/2011

Abstract

Background

Laparoscopic adjustable gastric banding (LAGB) is an effective bariatric procedure with low morbidity and mortality. Unfortunately, it is fraught with high failure rates in long-term follow-up. Laparoscopic sleeve gastrectomy (LSG) is an emerging procedure, quickly gaining momentum in the arsenal of bariatric practice as a first step toward gastric bypass/biliopancreatic diversion or as a stand-alone operation. Recently, it has been described as a revisional option for previous bariatric surgery failures. We report our early experience with LSG as a revisional procedure for failed LAGB.

Methods

From January 2007 to April 2010, 46 patients, who had undergone LAGB, underwent LSG. Patient demographics, reason for band removal, interval between removal and LSG, operative times, estimated blood loss, complications, length of hospital stay, and percent of excess weight loss were collected.

Results

Of the 46 patients, 20 (43%) had their bands removed before LSG (median time interval, 2 years; range, 2 months to 9 years); the rest had concomitant band removal and LSG. Twelve patients were men (26%). Mean age and BMI were 40 (range, 20–60) years and 43.1 kg/m² (range, 33–57), respectively. In two cases, surgery was converted to an open procedure due to extensive adhesions related to previous surgeries. Median operative time, estimated blood loss, and length of hospital stay were 118 (range, 70–250) minutes, 41 (range, 5–600) ml, and 3 (range, 1–100) days, respectively. Major morbidity was encountered in three patients (6%; leak in 2 and bleeding in 1). There were no mortalities. Mean follow-up time for our cohort is 17 (range, 1–39) months. Percent of excess weight loss at 2, 6, 12, 24, and 36 months was 24, 37, 53, 51, and 48%, respectively.

Conclusions

Our results suggest that LSG is safe, feasible, and effective as a revisional procedure for failed LAGB and can be considered as an appealing option in these cases. Larger series and longer follow-up are needed to confirm this.

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Title: Laparoscopic sleeve gastrectomy as a revisional option after gastric band failure
Authors: David Goitein
Anya Feigin
Gabriella Segal-Lieberman
Orly Goitein
Moshe Zvi Papa
Dov Zippel
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 8/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-011-1615-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic sleeve gastrectomy as a revisional option after gastric band failure

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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