Surgical Endoscopy

, Volume 27, Issue 11, pp 4087–4093 | Cite as

Revisional weight loss surgery after failed laparoscopic gastric banding: an institutional experience

  • Tung T. Tran
  • Eric Pauli
  • Jerome R. Lyn-Sue
  • Randy Haluck
  • Ann M. Rogers



Increasing experience with laparoscopic adjustable gastric banding (LAGB) has demonstrated a high rate of complications and inadequate weight loss. Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) have been reported to be safe and effective in selected patients. The purpose of our study was to evaluate the incidence and outcomes of revisional weight loss surgery (RWLS) after laparoscopic gastric banding at our institution.


From June 2006 to February 2013, all patients who underwent LAGB and those who required revision were retrospectively analyzed. All procedures were performed by two surgeons with extensive experience in bariatric surgery. Parametric data are presented as mean ± SD; nonparametric data are presented as median and interquartile range (IQR).


During the study period, 256 patients underwent LAGB. A total of 111 patients (43 %) required reoperation. Sixty-one patients (56 women, age = 43.7 ± 12 years) with a BMI of 45.4 ± 6 kg/m2 successfully underwent RWLS (53 RYGB, 8 LSG). Indications for RWLS included dysphagia (40 patients, 63 %), inadequate weight loss (17 patients, 27 %), GERD (2 patients, 3 %), gastric prolapse (2 patients, 3 %), and needle phobia (1 patient, 2 %). Two required conversion to an open RYGB due to extensive adhesions. RWLS was undertaken approximately 36.3 [25–45] months after LAGB. Removal of the gastric band and the RWLS were performed in 15 patients with an interval of 3 [1.5–7] months between procedures. Median operative time was 165 [142–184] min. Median hospital length of stay was 2 [2–3] days. Early complications occurred in 11 patients (18 %), including 4 anastomotic leaks. Twelve patients (20 %) presented with late complications requiring intervention. There was one death. At a median follow-up of 12.4 months, excess weight loss was 47.5 ± 27 %, and 48 % of patients achieved a BMI < 33.


LAGB is associated with a high incidence of reoperation. Reoperative weight loss surgery can be performed in selected patients with a higher rate of complications than primary surgery. Good short-term weight loss outcomes can be achieved.


Laparoscopic adjustable gastric banding Revisional weight loss surgery Obesity Bariatric surgery Complications 



Dr. Eric Pauli is a lecturer for Bard (Murray Hill, NJ), and Synthes (West Chester, PA) and a consultant for Synapse Biomedical (Oberlin, OH). Drs. Randy Haluck, Jerome Lyn-Sue, Ann Rogers, and Tung Tran have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Tung T. Tran
    • 1
  • Eric Pauli
    • 1
  • Jerome R. Lyn-Sue
    • 1
  • Randy Haluck
    • 1
  • Ann M. Rogers
    • 1
  1. 1.Division of Minimally Invasive/Bariatric Surgery, Department of SurgeryPenn State Milton S. Hershey Medical CenterHersheyUSA

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