Journal of Gastrointestinal Surgery

, Volume 18, Issue 10, pp 1737–1743 | Cite as

Primary Sleeve Gastrectomy Compared to Sleeve Gastrectomy as Revisional Surgery: Weight Loss and Complications at Intermediate Follow-up

  • Allison M. BarrettEmail author
  • Kim T. Vu
  • Kulmeet K. Sandhu
  • Edward H. Phillips
  • Scott A. Cunneen
  • Miguel A. Burch
Original Article



The laparoscopic adjustable gastric band (LAGB) can be revised to sleeve gastrectomy (LSG) for various reasons. Data are limited on the safety and efficacy of single-stage removal of LAGB and creation of LSG.


A retrospective review of cases was performed from 2010 to 2013. From the primary LSG group, a control group was matched in a 2:1 ratio.


Thirty-two patients underwent single-stage revision from LAGB to LSG, with a control group of 64. The most common indication for revision was insufficient weight loss (62.5 %). Operative time for revision and control groups was 134 and 92 min, respectively (p < 0.0001). Hospital stay was 3.22 and 2.59 days, respectively (p = 0.02). Overall, the 30-day complication rate for revision and control patients was 14.71 and 6.25 %, respectively (p = 0.20). There were no leaks, one stricture (3.13 %) in the revision group, and one reoperation for bleeding in the control group (1.56 %). For patients with BMI >30 at surgery, change in BMI at 12 months for revision and control was 8.77 and 11.58, respectively (p = 0.02).


Single-stage revision can be performed safely, with minimal increases in hospital stay and 30-day complications. Weight loss is greater in those who undergo primary LSG compared to those who undergo LSG as revision.


Bariatric Gastric band Laparoscopy Obesity Sleeve gastrectomy 





  1. 1.
    Tran TT, Pauli E, Lyn-Sue JR, Haluck R, Rogers AM. Revisional weight loss surgery after failed laparoscopic gastric banding: an institutional experience. Surg Endosc 2013; 27(11):4087–4093.PubMedCrossRefGoogle Scholar
  2. 2.
    Boza C, Gamboa C, Perez G, Crovari F, Escalona A, Pimentel F, Raddatz A, Guzman S, Ibanez L. Laparoscopic adjustable gastric banding (LAGB): surgical results and 5-year follow-up. Surg Endosc 2011;25:292–297.PubMedCrossRefGoogle Scholar
  3. 3.
    Van Nieuwenhove Y, Ceelen W, Stockman A, Vanommeslaeghe H, Snoeck E, Van Renterghem K, Van de Putte D, Pattyn P. Long-term results of a prospective study on laparoscopic adjustable gastric banding for morbid obesity. Obes Surg 2011;21:582–587.PubMedCrossRefGoogle Scholar
  4. 4.
    Scozzari G, Farinella E, Bonnet G, Toppino M, Morino M. Laparoscopic adjustable silicone gastric banding vs laparoscopic vertical banded gastroplasty in morbidly obese patients: long-term results of a prospective randomized controlled clinical trial. Obes Surg 2009;19:1108–1115.PubMedCrossRefGoogle Scholar
  5. 5.
    Miller K, Pump A, Hell E. Vertical banded gastroplasty versus adjustable gastric banding: prospective long-term follow-up study. Surg Obes Relat Dis 2007;3:84–90.PubMedCrossRefGoogle Scholar
  6. 6.
    Favretti F, Segato G, Ashton D, Busetto L, De Luca M, Mazza M, Ceoloni A, Banzato O, Calo E, Enzi G. Laparoscopic adjustable gastric banding in 1,791 consecutive obese patients: 12-year results. Obes Surg. 2007;17:168–175.PubMedCrossRefGoogle Scholar
  7. 7.
    Naef M, Mouton W, Naef U, Kummer O, Muggli B, Wagner H. Graft survival and complications after laparoscopic gastric banding for morbid obesity: lessons learned from a 12-year experience. Obes Surg. 2010;20:1206–1214.PubMedCrossRefGoogle Scholar
  8. 8.
    Himpens J, Cadiere GB, Bazi M, Vouche M, Cadiere B, Dapri G. Long-term outcomes of laparoscopic adjustable gastric banding. Arch Surg. 2011;146:802–807.PubMedCrossRefGoogle Scholar
  9. 9.
    Metropolitan Life Height & Weight Tables. Statistical Bulletin 1983; 64(1):2–9.Google Scholar
  10. 10.
    Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004; 240(2):205–213.PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    Sturm R, Hattori A. Morbid obesity rates continue to rise rapidly in the United States. Int Journal Obesity 2012; 37(6): 889–891.CrossRefGoogle Scholar
  12. 12.
    Christou NV, Sampalis JS, Liberman M, Look D, Auger S, McLean AP, MacLean LD. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg 2004; 240(3):416.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Lanthaler M, Aigner F, Kinzl J, Sieb M, Cakar-Beck F, Nehoda H. Long-term results and complications following adjustable gastric banding. Obes Surg 2010;20:1078–1085.PubMedCrossRefGoogle Scholar
  14. 14.
    Lanthaler M, Strasser S, Aigner F, Margreiter R, Nehoda H. Weight loss and quality of life after gastric band removal or deflation. ObesSurg 2009;19:1401–1408.Google Scholar
  15. 15.
    Aarts EO, Dogan K, Koehestanie P, Janssen I, Berends FJ. What happens after gastric band removal without additional bariatric surgery? Surgery Obesity Rel Dis 2013: ePub ahead of print 25 Oct 2013.Google Scholar
  16. 16.
    Goitein, D, Feigin A, Segal-Lieberman G, Goitein O, Papa MZ, Zippel D. Laparoscopic sleeve gastrectomy as a revisional option after gastric band failure. Surg Endosc 2011;25:2626–2630.PubMedCrossRefGoogle Scholar
  17. 17.
    Berende CAS, de Zoete JP, Smulders JF, Nienhuijs SW, Laparoscopic sleeve gastrectomy feasible for bariatric revision surgery. Obesity Surgery 2012;22:330–334.PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    Liu KH, Diana M, Vix M, Mutter D, Wu HS, Marescaux J. Revisional surgery after failed adjustable gastric banding: institutional experience with 90 consecutive cases. Surg Endosc 2013; 27:4044–4048.PubMedCrossRefGoogle Scholar
  19. 19.
    Westling A, Ohrvall M, Gustavsson S. Roux-en-Y gastric bypass after previous unsuccessful gastric restrictive surgery. J Gastrointest Surg 2002;6:206–211.PubMedCrossRefGoogle Scholar
  20. 20.
    Hii MW, Lake AC, Kenfield C, Hopkins GH. Laparoscopic conversion of failed gastric banding to Roux-en-Y gastric bypass: short-term follow-up and technical considerations. Obes Surg 2012;22:1022–1028.PubMedCrossRefGoogle Scholar
  21. 21.
    Westling A, Ohrvall M, Gustavsson S. Roux-en-Y gastric bypass after previous unsuccessful gastric restrictive surgery. J Gastrointest Surg 2002;6:206–211.PubMedCrossRefGoogle Scholar
  22. 22.
    Kothari SN, DeMaria EJ, Sugerman HJ, Kellum JM, Meador J, Wolfe L. Lap-band failures: conversion to gastric bypass and their preliminary outcomes. Surgery 2002;131(6):625–629.PubMedCrossRefGoogle Scholar
  23. 23.
    Moore R, Perugini R, Czerniach D, Gallagher-Dorval K, Mason R, Kelly JJ. Early results of conversion of laparoscopic adjustable gastric band to Roux-en-Y gastric bypass. Surg Obes Relat Dis 2009;5:439–443.PubMedCrossRefGoogle Scholar
  24. 24.
    Gelisgen R, Zengin K, Kocael A, Baysal B, Kocael P, Erman H, Taskin M, Uzun H. Effects of laparoscopic gastric band applications on plasma and fundic acylated ghrelin levels in morbidly obese patients. Obesity Surgery 2012;22:299–305.PubMedCrossRefGoogle Scholar
  25. 25.
    Burgmer R, Grigutsch K, Zipfel S, Wolf AM, de Zwaan M, Husemann B, Albus C, Senf W, Herpertz S. The influence of eating behavior and eating pathology on weight loss after gastric restriction operations. ObesSurg 2005;15:684–691.Google Scholar
  26. 26.
    Anderson B, Switzer NJ, Almamar A, Shi X, Birch DW, Karmali S. The impact of laparoscopic sleeve gastrectomy on plasma ghrelin levels: a systematic review. Obesity Surgery 2013;23:1476–1480.PubMedCrossRefGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2014

Authors and Affiliations

  • Allison M. Barrett
    • 1
    Email author
  • Kim T. Vu
    • 1
  • Kulmeet K. Sandhu
    • 2
  • Edward H. Phillips
    • 1
  • Scott A. Cunneen
    • 1
  • Miguel A. Burch
    • 1
  1. 1.Cedars-Sinai Medical CenterLos AngelesUSA
  2. 2.University of Southern CaliforniaLos AngelesUSA

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