Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 9/2015

01-09-2015

Revisions after failed gastric band: sleeve gastrectomy and Roux-en-Y gastric bypass

Authors: Raquel Gonzalez-Heredia, Mario Masrur, Kristin Patton, Vivek Bindal, Shravan Sarvepalli, Enrique Elli

Published in: Surgical Endoscopy | Issue 9/2015

Login to get access

Abstract

Introduction

Laparoscopic gastric band is an appealing bariatric operation due to its simplicity and good short-term outcomes; however, it is associated with complications (slippage, erosion, prolapse) and failure in reaching target weight loss. This study describes our experience with failed gastric bands that required a revisional procedure.

Materials and Methods

This single-center retrospective analysis includes all consecutive patients who underwent a gastric band removal and revisional surgery in our hospital from January 2008 to June 2014. A total of 81 patients were identified and divided in three groups: Group one included patients who just had the gastric band removed (43), group two consisted of patients who underwent a conversion to sleeve gastrectomy (SG) (26), and group three included patients who required a conversion to Roux-en Y gastric bypass (RYGB) (12). Patient demographics, date of gastric band placement, indications for revision, postoperative morbidity and mortality, operating time, blood loss, length of stay, and % excess weight loss (%EWL) were recorded. Perioperative and clinical outcomes were compared between conversions to SG and RYGB.

Results

In group two (n = 26), 21 conversions to SG were performed in concurrence with the band removal as a one-stage operation, while five procedures were performed in two-stages. There were no complications and no case was converted to open. Patients who underwent a one-stage procedure had a longer operative time, although it did not reach statistical significance. In group three, 12 patients underwent a conversion to RYGB as a revisional operation; 11 were performed as a one-stage procedure and only one patient underwent a two-stage procedure.

Conclusions

SG and RYGB are safe options to revise a failed gastric band. Both groups who received either a SG or RYGB had a low complication rate and acceptable %EWL with no statistical difference between the two.
Literature
1.
Khaodhiar L, McCowen KC, Blackburn GL (1999) Obesity and its comorbid conditions. Clin Cornerstone 2(3):17–31CrossRefPubMed
2.
3.
4.
5.
Fischer L et al (2012) Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg 22(5):721–731CrossRefPubMed
6.
Sjostrom L et al (2004) Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351(26):2683–2693CrossRefPubMed
7.
Chapman AE et al (2004) Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery 135(3):326–351CrossRefPubMed
8.
Boza C et al (2011) Laparoscopic adjustable gastric banding (LAGB): surgical results and 5-year follow-up. Surg Endosc 25(1):292–297CrossRefPubMed
9.
Tice JA et al (2008) Gastric banding or bypass? A systematic review comparing the two most popular bariatric procedures. Am J Med 121(10):885–893CrossRefPubMed
10.
Elnahas A et al (2013) Revisional surgery after failed laparoscopic adjustable gastric banding: a systematic review. Surg Endosc 27(3):740–745CrossRefPubMed
11.
Colquitt JL et al (2009) Surgery for obesity. Cochrane Database Syst Rev 2:CD003641
12.
Kellogg TA et al (2009) Patterns of readmission and reoperation within 90 days after Roux-en-Y gastric bypass. Surg Obes Relat Dis 5(4):416–423CrossRefPubMed
13.
Ardestani A, Lautz DB, Tavakkolizadeh A (2011) Band revision versus Roux-en-Y gastric bypass conversion as salvage operation after laparoscopic adjustable gastric banding. Surg Obes Relat Dis 7(1):33–37CrossRefPubMed
14.
Vella M, Galloway DJ (2003) Laparoscopic adjustable gastric banding for severe obesity. Obes Surg 13(4):642–648CrossRefPubMed
15.
Hii MW et al (2012) Laparoscopic conversion of failed gastric banding to Roux-en-Y gastric bypass: short-term follow-up and technical considerations. Obes Surg 22(7):1022–1028CrossRefPubMed
16.
Suter M et al (2006) A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg 16(7):829–835CrossRefPubMed
17.
Chevallier JM et al (2004) Complications after laparoscopic adjustable gastric banding for morbid obesity: experience with 1,000 patients over 7 years. Obes Surg 14(3):407–414CrossRefPubMed
18.
Dargent J (2005) Esophageal dilatation after laparoscopic adjustable gastric banding: definition and strategy. Obes Surg 15(6):843–848CrossRefPubMed
19.
Angrisani L et al (2003) Lap Band adjustable gastric banding system: the Italian experience with 1863 patients operated on 6 years. Surg Endosc 17(3):409–412CrossRefPubMed
20.
Cherian PT et al (2010) Band erosion after laparoscopic gastric banding: a retrospective analysis of 865 patients over 5 years. Surg Endosc 24(8):2031–2038CrossRefPubMed
21.
Moore R et al (2009) Early results of conversion of laparoscopic adjustable gastric band to Roux-en-Y gastric bypass. Surg Obes Relat Dis 5(4):439–443CrossRefPubMed
22.
Van Nieuwenhove Y et al (2011) Conversion from band to bypass in two steps reduces the risk for anastomotic strictures. Obes Surg 21(4):501–505CrossRefPubMed
23.
Langer FB et al (2008) Inadequate weight loss vs secondary weight regain: laparoscopic conversion from gastric banding to Roux-en-Y gastric bypass. Obes Surg 18(11):1381–1386CrossRefPubMed
24.
Must A et al (1999) The disease burden associated with overweight and obesity. JAMA 282(16):1523–1529CrossRefPubMed
25.
Foletto M et al (2010) Sleeve gastrectomy as revisional procedure for failed gastric banding or gastroplasty. Surg Obes Relat Dis 6(2):146–151CrossRefPubMed
26.
Stroh C et al (2014) Is a one-step sleeve gastrectomy indicated as a revision procedure after gastric banding? Data analysis from a quality assurance study of the surgical treatment of obesity in Germany. Obes Surg 24(1):9–14CrossRefPubMed
27.
Silecchia G et al (2013) Laparoscopic sleeve gastrectomy as a revisional procedure for failed laparoscopic gastric banding with a “2-step approach”: a multicenter study. Surg Obes Relat Dis 10(4):626–631
28.
29.
Bernante P et al (2006) Feasibility of laparoscopic sleeve gastrectomy as a revision procedure for prior laparoscopic gastric banding. Obes Surg 16(10):1327–1330CrossRefPubMed
30.
Acholonu E et al (2009) Safety and short-term outcomes of laparoscopic sleeve gastrectomy as a revisional approach for failed laparoscopic adjustable gastric banding in the treatment of morbid obesity. Obes Surg 19(12):1612–1616CrossRefPubMed
31.
Utech M et al (2013) Sleeve Gastrectomy as a Revision Procedure for Failed Gastric Banding. Zentralbl Chir 139(1):79–82
32.
Marin-Perez P et al (2014) Outcomes after laparoscopic conversion of failed adjustable gastric banding to sleeve gastrectomy or Roux-en-Y gastric bypass. Br J Surg 101(3):254–260CrossRefPubMed
Metadata
Title
Revisions after failed gastric band: sleeve gastrectomy and Roux-en-Y gastric bypass
Authors
Raquel Gonzalez-Heredia
Mario Masrur
Kristin Patton
Vivek Bindal
Shravan Sarvepalli
Enrique Elli
Publication date
01-09-2015
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 9/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-3995-7

Other articles of this Issue 9/2015

Surgical Endoscopy 9/2015 Go to the issue

OriginalPaper

The use of self-gripping (Progrip™) mesh during laparoscopic total extraperitoneal (TEP) inguinal hernia repair: a prospective feasibility and long-term outcomes study

Dynamic Manuscript

Peroral endoscopic myotomy for advanced achalasia with sigmoid-shaped esophagus: long-term outcomes from a prospective, single-center study

OriginalPaper

The effect of ergonomic laparoscopic tool handle design on performance and efficiency

OriginalPaper

Laparoscopy has a superior diagnostic yield than percutaneous image-guided biopsy for suspected intra-abdominal lymphoma

OriginalPaper

A comparison of robotic surgery in children weighing above and below 15.0 kg: size does not affect surgery success

OriginalPaper

Preoperative endoscopy localization error rate in patients with colorectal cancer