Although laparoscopic adjustable gastric banding (LAGB) has been found to be a generally successful weight loss operation, many patients require revision for weight regain, mechanical complications or intolerance to restriction. We report our experience with laparoscopic mini-gastric bypass (LMGB) as a revisional procedure for failed primary LAGB. From June 2007 to November 2012, 48 patients, who had undergone LAGB, underwent revisional surgery to LMGB. Patient demographics, reasons for band removal, interval between removal and LMGB, operative times, complications, change in comorbidities, and weight loss were collected. The revisions to a mini-gastric bypass (MGB) were completed laparoscopically in all cases except in four, when the MGB was deferred because of gastric tube damage. Mean age was 38 years (range 20–59) and BMI was 43.4 ± 4.2 kg/m2; 82 % of patients were females. Revision was performed after a mean of 28.6 months. The mean hospital stay was 3.25 days. Within 60 days of the MGB, mortality and morbidity were nil. We observed a significant difference in mean BMI after 6 months’ follow-up (P < 0.001). Diabetes remission was observed in 88 % of patients, apnea remission in 66 %, and hypertension remission in 66 % after LMGB (p < 0.001). Moreover, four patients with GERD were cured. All LAGB patients had positive outcomes after the conversion to MGB, with a mean gain of 1.7 points in the bariatric analysis and reporting outcome system questionnaire. Our results suggested that LMGB is a safe, feasible, effective and easy-to-perform revisional procedure for failed LAGB.
Laparoscopic adjustable gastric banding Laparoscopic mini-gastric bypass Obesity Revisional surgery Bariatric surgery
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Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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.
Research involving human participants and/or animals
No animals but only human participants were engaged in our study.
Informed consent was obtained from all individual participants included in the study.
Biondi A, Grosso G, Mistretta A, Marventano S, Toscano C, Drago F, Gangi S, Basile F (2013) Laparoscopic vs. open approach for colorectal cancer: evolution over time of minimal invasive surgery. BMC Surg 13(Suppl 2):S12PubMedCentralPubMedCrossRefGoogle Scholar
Biondi A, Grosso G, Mistretta A, Marventano S, Toscano C, Gruttadauria S, Basile F (2013) Laparoscopic-assisted versus open surgery for colorectal cancer: short- and long-term outcomes comparison. J Laparoendosc Adv Surg Tech A 23:1–7PubMedCentralPubMedCrossRefGoogle Scholar
Agresta F, De Simone P, Leone L, Arezzo A, Biondi A, Bottero L, Italian Society Of Young Surgeons (SPIGC) et al (2004) Laparoscopic appendectomy in Italy: an appraisal of 26,863 cases. J Laparoendosc Adv Surg Tech A 14:1–8PubMedCrossRefGoogle Scholar
Grosso G, Biondi A, Marventano S, Mistretta A, Calabrese G, Basile F (2012) Major postoperative complications and survival for colon cancer elderly patients. BMC Surg 12(Suppl 1):S20PubMedCentralPubMedCrossRefGoogle Scholar
Robert M, Poncet J, Boulez J, Mion F, Espalieu P (2011) Laparoscopic gastric bypass for failure of adjustable gastric banding: a review of 85 cases. Obes Surg 21:1513–1519PubMedCrossRefGoogle Scholar
Suter M, Calmes JM, Paroz A et al (2006) A 10-years experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg 16:829–835PubMedCrossRefGoogle Scholar
Topart P, Becouarn G, Ritz P (2009) One-year weight loss after primary or revisional Roux-en-Y gastric bypass for failed adjustable gastric banding. Surg Obes Relat Dis 5:459–462PubMedCrossRefGoogle Scholar
De Maria EJ, Sugerman HJ, Meador JG et al (2001) High failure rate after laparoscopic adjustable silicone gastric banding for treatment of morbid obesity. Ann Surg 223:809–818Google Scholar
Bueter M, Thalheimer A, Wierlemann A et al (2009) Reoperations after gastric banding: replacement or alternative procedure? Surg Endosc 23:334–340PubMedCrossRefGoogle Scholar
Weiss HG, Kirchmayr W, Klaus A et al (2004) Surgical revision after failure of laparoscopic adjustable gastric banding. Br J Surg 91:235–241PubMedCrossRefGoogle Scholar
Westling A, Ohrvall M, Gustavsson S (2002) Roux-en-Y gastric bypass after previous unsuccessful gastric restrictive surgery. J Gastrointest Surg 6:206–211PubMedCrossRefGoogle Scholar
Gagner M, Gentileschi P, De Csepel J et al (2002) Laparoscopic reoperative bariatric surgery: experience from 27 consecutive patients. Obes Surg 12:254–260PubMedCrossRefGoogle Scholar
Peterli R, Donadini A, Peters T, Ackermann C, Tondelli P (2002) Re-operations following laparoscopic adjustable gastric banding. Obes Surg 12:851–856PubMedCrossRefGoogle Scholar
Weber M, Muller MK, Michael JM et al (2003) Laparoscopic Roux-en-Y gastric bypass, but notrebanding, should be proposed as rescue procedure for patients with failed laparoscopic gastric banding. Ann Surg 238:827–833PubMedCentralPubMedCrossRefGoogle Scholar
Rutledge R, Walsh TR (2005) Continued excellent results with the mini-gastric bypass: six year study in 2410 patients. Obes Sur. 15:1304–1308CrossRefGoogle Scholar
Lee Wei-Jei, Yu Po-Jui, Wang Weu, Chen Tai-Chi, Wei Po-Li, Huang Ming-Te (2005) Laparoscopic Roux-en-Y versus mini gastric bypass for the treatment of morbid obesity. Ann Surg 242:20–28PubMedCentralPubMedCrossRefGoogle Scholar
Noun R, Skaff J, Riachi E, Daher R, Antoun NA, Nasr N (2012) One thousand consecutive mini-gastric bypass: short and long term outcome. Obes Surg 22:697–703PubMedCrossRefGoogle Scholar
Piazza L, Ferrara F, Bellia A, Leanza S, Coco D, Sarvà S, Di Stefano C, Basile F, Biondi A (2011) Laparoscopic mini-gastric bypass: short-term single-institute experience. Updates Surg 63:239–242PubMedCrossRefGoogle Scholar
Chevallier J-M, Zinzindohoué F, Douard R et al (2004) Complications after laparoscopic adjustable gastric banding for morbid obesity: experience with 1,000 patients over 7 years. Obes Surg 14:407–414PubMedCrossRefGoogle Scholar
Samuel I, Mason EE, Renquist KE et al (2006) Bariatric surgery trends: an 18-year report from the international bariatric surgery registry. Am J Surg 192:657–662PubMedCrossRefGoogle Scholar
Shouten R, Van Dielen FM, Greve JW (2006) Re-operation after laparoscopic adjustable gastric banding leads to a further decrease in BMI and obesity-related co-morbidities: results in 33 patients. Obes Surg 16:821–828CrossRefGoogle Scholar
Nesset EM, Kendrick ML, Hounghton SG et al (2007) A two-decade spectrum of revisional bariatric surgery at a tertiary referral center. Surg Obes Relat Dis 3:25–30PubMedCrossRefGoogle Scholar
Roller JE, Provost DA (2006) Revision of failed gastric restrictive operations to Roux-en-Y gastric bypass: impact of multiple prior bariatric operations on outcome. Obes Surg 16:865–869PubMedCrossRefGoogle Scholar