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To Band or Not to Band—Early Results of Banded Sleeve Gastrectomy

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Abstract

Laparoscopic sleeve gastrectomy (LSG) is the procedure with the fastest growing numbers worldwide. Although excellent weight loss can be achieved, one major obstacle of LSG is weight regain due to sleeve dilatation. Banded sleeve gastrectomy (BLSG) has been described as an option to counteract sleeve dilatation and ameliorate weight loss over time. In a retrospective study, we analysed 25 patients who underwent BLSG using a MiniMizer® ring. Twenty five patients who had previously undergone a conventional LSG were selected for matched-pair analysis. Patient follow-up was 12 months in both groups. Mean preoperative BMI was 56.1 ± 7.2 kg/m2 for BLSG and 57.0 ± 6.3 kg/m2 for LSG, P = 0.522. Operative time was significantly shorter for BLSG (53 ± 27 min vs. 68 ± 20 min, P = 0.0025). Excess weight loss (%EWL) was equal in both groups with %EWL at 12 months of 58.0 ± 14.6 % for BSLG patients vs. 58.4 ± 19.2 % for LSG patients. There was no procedure-related mortality in either group. At 12 months postoperative, vomiting was significantly increased in BSLG patients (OR 6.75, P = 0.035). New onset reflux was equal in both groups (OR 0.67, P = 0.469). Ring implantation does not increase the duration of surgery or early surgical complications. Weight loss in the first follow-up year is not influenced, but the incidence of vomiting is raised after 12 months when patients start to increase eating volume.

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References

  1. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.

    Article  PubMed  Google Scholar 

  2. Rosenthal RJ, International Sleeve Gastrectomy Expert Panel, Diaz AA, et al. International sleeve gastrectomy expert panel consensus statement: best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis. 2012;8(1):8–19.

    Article  PubMed  Google Scholar 

  3. Vidal P, Ramón JM, Goday A, et al. Laparoscopic gastric bypass versus laparoscopic sleeve gastrectomy as a definitive surgical procedure for morbid obesity. Mid-term results. Obes Surg. 2013;23(3):292–9.

    Article  PubMed  Google Scholar 

  4. Karcz WK, Krawczykowski D, Kuesters S, et al. Influence of sleeve gastrectomy on NASH and type 2 diabetes mellitus. J Obes. 2011;2011:765473.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  5. Deguines JB, Verhaeghe P, Yzet T, et al. Is the residual gastric volume after laparoscopic sleeve gastrectomy an objective criterion for adapting the treatment strategy after failure? Surg Obes Relat Dis. 2013;9(5):660–6.

    Article  PubMed  Google Scholar 

  6. Baumann T, Grueneberger J, Pache G, et al. Three-dimensional stomach analysis with computed tomography after laparoscopic sleeve gastrectomy: sleeve dilation and thoracic migration. Surg Endosc. 2011;25(7):2323–9.

    Article  PubMed  Google Scholar 

  7. Karcz WK, Marjanovic G, Grueneberger J, et al. Banded sleeve gastrectomy using the GaBP ring–surgical technique. Obes Facts. 2011;4(1):77–80.

    Article  PubMed  Google Scholar 

  8. Alexander JW, Martin Hawver LR, Goodman HR. Banded sleeve gastrectomy--initial experience. Obes Surg. 2009;19(11):1591–6.

    Article  PubMed  Google Scholar 

  9. Konrad KW, Kuesters S, Baumann T, et al. Sleevopexy as reflux prevention after sleeve gastrectomy-surgical technique. Abdom Wall Repair J. 2013;1(2):19–22.

    Google Scholar 

  10. Mason EE, Doherty C, Cullen JJ, et al. Vertical gastroplasty: evolution of vertical banded gastroplasty. World J Surg. 1998;22(9):919–24.

    Article  PubMed  CAS  Google Scholar 

  11. Awad W, Garay A, Martinez C. Ten years experience of banded gastric bypass: does it make a difference? Obes Surg. 2012;22(2):271–8.

    Article  PubMed  Google Scholar 

  12. Fischer L, Hildebrandt C, Bruckner T, et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg. 2012;22(5):721–31.

    Article  PubMed  Google Scholar 

  13. Karcz WK, Kuesters S, Marjanovic G, et al. 3D-MSCT gastric pouch volumetry in bariatric surgery-preliminary clinical results. Obes Surg. 2009;19(4):508–16.

    Article  PubMed  CAS  Google Scholar 

  14. Braghetto I, Cortes C, Herquiñigo D, et al. Evaluation of the radiological gastric capacity and evolution of the BMI 2-3 years after sleeve gastrectomy. Obes Surg. 2009;19(9):1262–9.

    Article  PubMed  Google Scholar 

  15. Burton PR, Brown WA. The mechanism of weight loss with laparoscopic adjustable gastric banding: induction of satiety not restriction. Int J Obes (Lond). 2011;35 Suppl 3:S26–30.

    Article  Google Scholar 

  16. Yousseif A, Emmanuel J, Karra E, et al. Differential effects of laparoscopic sleeve gastrectomy and laparoscopic gastric bypass on appetite, circulating Acyl-ghrelin, peptide YY3-36 and active GLP-1 levels in non-diabetic humans. Obes Surg. 2013;24(2):241–52.

    Article  PubMed Central  Google Scholar 

  17. Baumann T, Kuesters S, Grueneberger J, et al. Time-resolved MRI after ingestion of liquids reveals motility changes after laparoscopic sleeve gastrectomy–preliminary results. Obes Surg. 2011;21(1):95–101.

    Article  PubMed  Google Scholar 

  18. Bessler M, Daud A, Kim T, et al. Prospective randomized trial of banded versus nonbanded gastric bypass for the super obese: early results. Surg Obes Relat Dis. 2007;3(4):480–4. discussion 484-5.

    Article  PubMed  Google Scholar 

  19. le Roux CW, Welbourn R, Werling M, et al. Gut hormones as mediators of appetite and weight loss after Roux-en-Y gastric bypass. Ann Surg. 2007;246(5):780–5.

    Article  PubMed  Google Scholar 

  20. Karcz W. To have or not to have the ring: early and late surgical complications after banded Roux-en-Y gastric bypass. Videosurg Other Miniinvasive Tech. 2008;3(2):53–65.

    Google Scholar 

  21. Stubbs RS, O'Brien I, Jurikova L. What ring size should be used in association with vertical gastric bypass? Obes Surg. 2006;16(10):1298–303.

    Article  PubMed  Google Scholar 

  22. Taddeucci RJ, Madan AK, Ternovits CA, et al. Laparoscopic re-operations for band removal after open banded gastric bypass. Obes Surg. 2007;17(1):35–8.

    Article  PubMed  Google Scholar 

  23. Mason EE, Cullen JJ. Management of complications in vertical banded gastroplasty. Curr Surg. 2003;60(1):33–7.

    Article  PubMed  Google Scholar 

  24. Bekheit M, Katri K, Salam WN, et al. Rejecting the demise of vertical-banded gastroplasty: a long-term single-institute experience. Obes Surg. 2013;23(10):1604–10.

    Article  PubMed  Google Scholar 

  25. Ferraz A, Campos J, Dib V, et al. Food intolerance after banded gastric bypass without stenosis: aggressive endoscopic dilation avoids reoperation. Obes Surg. 2013;23(7):959–64.

    Article  PubMed  Google Scholar 

  26. Slater NJ, van der Kolk M, Hendriks T, et al. Biologic grafts for ventral hernia repair: a systematic review. Am J Surg. 2013;205(2):220–30.

    Article  PubMed  Google Scholar 

  27. Lazoura O, Zacharoulis D, Triantafyllidis G, et al. Symptoms of gastroesophageal reflux following laparoscopic sleeve gastrectomy are related to the final shape of the sleeve as depicted by radiology. Obes Surg. 2011;21(3):295–9.

    Article  PubMed  Google Scholar 

  28. Woodman G, Cywes R, Billy H, et al. Effect of adjustable gastric banding on changes in gastroesophageal reflux disease (GERD) and quality of life. Curr Med Res Opin. 2012;28(4):581–9.

    Article  PubMed  Google Scholar 

  29. Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16(11):1450–6.

    Article  PubMed  Google Scholar 

  30. Rebecchi F, Rocchietto S, Giaccone C, et al. Gastroesophageal reflux disease and esophageal motility in morbidly obese patients submitted to laparoscopic adjustable silicone gastric banding or laparoscopic vertical banded gastroplasty. Surg Endosc. 2011;25(3):795–803.

    Article  PubMed  Google Scholar 

  31. Deitel M, Khanna RK, Hagen J, et al. Vertical banded gastroplasty as an antireflux procedure. Am J Surg. 1988;155(3):512–6.

    Article  PubMed  CAS  Google Scholar 

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Conflict of Interest

W. Konrad Karcz, Iwona Karcz-Socha, Goran Marjanovic, Simon Kuesters, Matthias Goos, Ulrich T. Hopt, Tomasz Szewczyk, Tobias Baumann and Jodok Matthias Grueneberger declare to have no conflicts of interest.

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Authors and Affiliations

  1. Department of General Surgery, University of Schleswig-Holstein, Campus, Lübeck, Germany

    W. Konrad Karcz

  2. Department of Physiology, Medical University of Silesia, Katowice, Poland

    Iwona Karcz-Socha

  3. Department of General and Visceral Surgery, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg im Breisgau, Germany

    Goran Marjanovic, Simon Kuesters, Matthias Goos, Ulrich T. Hopt & Jodok Matthias Grueneberger

  4. Department of Gastrointestinal Surgery, University of Łódź, Łódź, Poland

    Tomasz Szewczyk

  5. Department of Radiology, University of Freiburg, Freiburg im Breisgau, Germany

    Tobias Baumann

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  1. W. Konrad Karcz
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  2. Iwona Karcz-Socha
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  3. Goran Marjanovic
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  4. Simon Kuesters
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  6. Ulrich T. Hopt
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  7. Tomasz Szewczyk
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  8. Tobias Baumann
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  9. Jodok Matthias Grueneberger
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Correspondence to Jodok Matthias Grueneberger.

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Karcz, W.K., Karcz-Socha, I., Marjanovic, G. et al. To Band or Not to Band—Early Results of Banded Sleeve Gastrectomy. OBES SURG 24, 660–665 (2014). https://doi.org/10.1007/s11695-014-1189-y

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  • DOI: https://doi.org/10.1007/s11695-014-1189-y

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