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Laparoscopic Revision for Gastric Clipping: a Single Center Experience and Taiwan Database Review

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Abstract

Purpose

Laparoscopic gastric clipping (LGC) is a relatively novel restrictive bariatric surgery wherein a horizontal metallic clip is applied to the gastric fundus. Its intraoperative complications or the difficulties associated with the applied gastric clip (GC) during revisional procedures have seldom been mentioned. Herein, the experience of revisional procedures after initial gastric clipping is reported.

Materials and Methods

A retrospective cohort review of LGC based on the Taiwan Bariatric Registry of Taiwan Society Metabolic and Bariatric Surgery was performed. Six patients with severe obesity presented for revisional surgery after initial LGC by other surgeons. Patients’ characteristics, indications, and details of revisional surgery were recorded.

Results

Between 2012 and 2019, 39 patients who underwent pure LGC and six patients with previous LGC history were referred for revisional surgery. Their mean age and the mean body mass index were 34.7 ± 9.5 years and 38.4 ± 10.5 kg/m2, respectively. Three, two, and one patient underwent revisional surgery for insufficient weight loss, weight recidivism, and intractable belching, respectively. The mean interval between initial LGC and revisional surgery was 40.5 ± 22.4 months. Laparoscopic removal of the GC with concomitant revisional surgeries were collected, including a revision to sleeve gastrectomy (n = 5) and revision to Roux-en-Y gastric bypass (n = 1). Moreover, the mean operative time was 286.8 ± 78.2 min. All patients had uneventful recovery postoperatively but experienced significant adhesion around the GC and the left liver.

Conclusion

Laparoscopic revisional surgery with concomitant GC removal for patients with severe obesity after gastric clipping could be feasibly conducted by experienced bariatric surgeons.

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Acknowledgements

The authors acknowledge the support of Enago (www.enago.tw) for the English language review. The authors appreciate the great contribution of TBR from TSMBS.

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Authors and Affiliations

  1. Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan

    Po-Chih Chang

  2. Weight Management Center, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan

    Po-Chih Chang & Ivy Ya-Wei Huang

  3. PhD Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan

    Po-Chih Chang

  4. Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan

    Po-Chih Chang

  5. Department of Surgery, Kaohsiung Medical University Hospital/Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung City, 80756, Taiwan

    Kai-Hua Chen & Ting-Wei Chang

  6. Department of Nursing, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan

    Ivy Ya-Wei Huang

  7. Body Science & Metabolic Disorders International Medical Center, China Medical University Hospital, Taichung City, Taiwan

    Chih-Kun Huang

  8. Division of General Surgery, Department of Surgery, E-Da Hospital/I-Shou University, Kaohsiung City, Taiwan

    Chung-Yen Chen

  9. Department of Surgery, Park One International Hospital, Kaohsiung City, Taiwan

    Ming-Yu Wang

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  1. Po-Chih Chang
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  2. Kai-Hua Chen
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  7. Ting-Wei Chang
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Corresponding author

Correspondence to Ting-Wei Chang.

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Ethical Statement

This is a retrospective cohort study approved by the Institutional Review Board of our tertiary medical center (KMUHIRB-E(II)-20200251).

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Informed consent was obtained from all participants enrolled in this study.

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The authors declare no competing interests.

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Chang, PC., Chen, KH., Huang, I.YW. et al. Laparoscopic Revision for Gastric Clipping: a Single Center Experience and Taiwan Database Review. OBES SURG 31, 3653–3659 (2021). https://doi.org/10.1007/s11695-021-05466-y

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  • DOI: https://doi.org/10.1007/s11695-021-05466-y

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