To Band or Not to Band—Early Results of Banded Sleeve Gastrectomy
First Online: 25 January 2014 DOI:
10.1007/s11695-014-1189-y Cite this article as: Karcz, W.K., Karcz-Socha, I., Marjanovic, G. et al. OBES SURG (2014) 24: 660. doi:10.1007/s11695-014-1189-y 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/m
2 for BLSG and 57.0 ± 6.3 kg/m 2 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. Keywords Banded sleeve gastrectomy BLSG Restriction Obesity surgery Weight loss References
Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.
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.
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.
Karcz WK, Krawczykowski D, Kuesters S, et al. Influence of sleeve gastrectomy on NASH and type 2 diabetes mellitus. J Obes. 2011;2011:765473.
PubMedCentral PubMed CrossRef
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.
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.
Karcz WK, Marjanovic G, Grueneberger J, et al. Banded sleeve gastrectomy using the GaBP ring–surgical technique. Obes Facts. 2011;4(1):77–80.
Alexander JW, Martin Hawver LR, Goodman HR. Banded sleeve gastrectomy--initial experience. Obes Surg. 2009;19(11):1591–6.
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.
Mason EE, Doherty C, Cullen JJ, et al. Vertical gastroplasty: evolution of vertical banded gastroplasty. World J Surg. 1998;22(9):919–24.
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.
Fischer L, Hildebrandt C, Bruckner T, et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg. 2012;22(5):721–31.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Mason EE, Cullen JJ. Management of complications in vertical banded gastroplasty. Curr Surg. 2003;60(1):33–7.
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.
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.
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.
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.
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.
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.
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.
Deitel M, Khanna RK, Hagen J, et al. Vertical banded gastroplasty as an antireflux procedure. Am J Surg. 1988;155(3):512–6.
PubMed CrossRef Copyright information
© Springer Science+Business Media New York 2014