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Lap Banding as a Redo Surgery: “Restriction over Restriction” May Be a Relevant Bariatric Strategy

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Abstract

Background

The redo issue is a growing and debated issue in bariatric surgery. From the experience of failed vertical banded gastroplasty (VBG), we suggest that adjustable gastric band is a relevant method in many cases.

Methods

Ninety-eight patients have been operated on in a 13-year period (07/1995–07/2008). The cause of VBG failure has been staple disruption in 58% of cases and an outlet enlargement in 37% of cases. In the meantime, two gastric bypasses have been performed. Mean body mass index has been 38 (28–48) and was less than 35 in 37% of the cases.

Results

Postoperative complications occurred in seven cases, and the band had to be removed in five cases. Mean excess weight loss has been 52% at 8 years, yet 22% of the patients have been lost for follow-up. Slippage occurred in two patients and erosion in one. A final removal of the band has been necessary in two patients.

Conclusions

VBG failures are highly common in the long run. Lap banding represents an interesting option for redo in a majority of cases, providing good long-term results and demonstrating that “restriction over restriction” can be a relevant strategy. The initial response to VBG has been a key information: if it has been successful in terms of weight loss and food tolerance, then lap banding was a valuable option. VBG has represented an interesting model because it has historical value and could be a procedure for the future if performed through endoscopic channels.

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  1. Polyclinique de Rillieux, 941, Rue Capitaine Julien, 69165, Rillieux-la-Pape Cedex, France

    Jérôme Dargent

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  1. Jérôme Dargent
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Correspondence to Jérôme Dargent.

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Dargent, J. Lap Banding as a Redo Surgery: “Restriction over Restriction” May Be a Relevant Bariatric Strategy. OBES SURG 19, 1243–1249 (2009). https://doi.org/10.1007/s11695-009-9876-9

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