Abstract
Background
Conversion of laparoscopic adjustable gastric banding (LAGB) to other operations is commonly done for significant weight recidivism and complications.
Methods
This is a consecutive series of LAGB converted to RYGB done at the Bariatric and Metabolic Institute (BMI) Abu Dhabi from 2009 to 2013 for weight recidivism. Our preferred approach is to convert LAGB to LRYGB in one stage. All patients undergo upper endoscopy (EGD) and upper gastrointestinal series and are started on clears liquids 2 h after surgery without performing UGI studies. This video outlines the steps as well as tips and tricks in converting LAGB to hand-sewn ante-colic ante-gastric RYGB in one stage.
Results
We performed 40 cases of conversion of LAGB to LRYGB in one or two stages, 80 % were females, mean age was 36.7 years (range 20–53), initial mean BMI was 48 kg/m2 (range 35–62), initial weight was 134.6 kg (range 80–220), and weight prior to conversion to RYGB was 131.8 kg (range 90–195). We converted LAGB to RYGB in one stage in 79.4 % (27/34); 6 patients presented to us after LAGB removal. Mean EWL% at 2 years was 60 % (18–111 %). Mortality was 0 %, conversion to open 0 %, blood transfusion 2.5 %, leak was 5 %, and 7.5 % patients developed gall stones and needed cholecystectomy. Follow-up was complete for 85 % of patients (34/40).
Conclusions
Conversion of LAGB to RYGB in one step can be performed with acceptable morbidity but provides lower weight loss than expected from primary RYGB at 2 years.
Similar content being viewed by others
References
Hutter MM, Schirmer BD, Jones DB, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg. 2011;254(3):410–20 discussion 420-2.
Aarts EO, Dogan K, Koehestanie P, et al. Long-term results after laparoscopic adjustable gastric banding: a mean fourteen year follow-up study. Surg Obes Relat Dis. 2014;10(4):633–40.
Mahawar KK, Graham Y, Carr WR, et al. Revisional Roux-en-Y gastric bypass and sleeve gastrectomy: a systematic review of comparative outcomes with respective primary procedures. Obes Surg. 2015;25(7):1271–80. doi:10.1007/s11695-015-1670-2.
Marin-Perez P, Betancourt A, Lamota M, et al. Outcomes after laparoscopic conversion of failed adjustable gastric banding to sleeve gastrectomy or Roux-en-Y gastric bypass. Br J Surg. 2014;101(3):254–60.
Nimeri AA, Maasher A, Al Shaban T, et al. Internal Hernia following laparoscopic Roux-en-Y gastric bypass: prevention and tips for intra-operative management. Obes Surg. 2016;26(9): 2255–6.
Al Hadad M, Dehni N, Elamin D, et al. Intraoperative endoscopy decreases postoperative complications in laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2015;25(9):1711–5.
Dang JT, Switzer NJ, Wu J, et al. Gastric band removal in revisional bariatric surgery, one-step versus two-step: a systematic review and meta-analysis. Obes Surg. 2016;26(4):866–73. doi:10.1007/s11695-016-2082-7.
Moon RC et al. Conversion of failed laparoscopic adjustable gastric banding: sleeve gastrectomy or Roux-en-Y gastric bypass? Surg Obes Relat Dis. 2013;9(6):901–7.
Enlahas A, Graybiel K, Farrokhyar F, et al. Revisional surgery after laparoscopic adjustable gastric banding: systematic review. Surg Endosc. 2013;27(3):740–5. doi:10.1007/s00464-012-2510-2.
Delko T, Köstler T, Peev M, et al. Revisional versus primary Roux-en-Y gastric bypass: a case-matched analysis. Surg Endosc. 2014;28(2):552–8. doi:10.1007/s00464-013-3204-0.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors have no conflict of interest declared.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study, formal consent is not required.
Electronic supplementary material
ESM 1
(MP4 165,488 kb)
Rights and permissions
About this article
Cite this article
Nimeri, A.A., Maasher, A., Al Shaban, T. et al. Tips and Tricks of Converting Laparoscopic Adjustable Gastric Banding to Roux-en-Y Gastric Bypass in one Stage. OBES SURG 26, 3066–3068 (2016). https://doi.org/10.1007/s11695-016-2401-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-016-2401-z