Laparoscopic adjustable gastric banding (LAGB) is one of the most frequently performed bariatric surgeries. Even with a high failure rate, revisional procedures such as re-banding or laparoscopic Roux-en-Y gastric bypass (LRYGB) were commonly performed. Recently, conversions of LAGB to laparoscopic sleeve gastrectomy (LSG) were reported. We will review our experience on this conversion.
Between February 2007 and January 2012, 800 patients underwent LSG, with 90 as a revisional procedure for failed LAGB. A retrospective review of a prospectively collected database was performed. Data were collected through routine follow-up and weight loss data were also obtained through self-reporting via the Internet. Demographics, complications, and percentage of excess weight loss (%EWL) were determined.
A total of 90 patients underwent LSG as a revisional procedure, comprising of 77 women and 13 men with a mean age of 41 years (22 to 67), a mean body mass index of 42 kg/m2 (26 to 58). Among them, 15.5 % had diabetes mellitus, 35.5 % had hypertension, 20.0 % had hyperlipidemia, and 18.8 % had obstructive sleep apnea. The mean operative time was 112 min (50 to 220) and mean hospital stay was 4.2 days (1 to 180). Operative complications included 5.5 % leak and 4.4 % hemorrhage or gastric hematoma. There was no postoperative mortality. The mean postoperative %EWL was 51.8 % (n = 82), 61.3 % (n = 60), 61.6 % (n = 45), 53.0 % (n = 30), 55.3 % (n = 20), and 54.1 % (n = 10) at 6, 12, 18, 24, 36, and 48 months, respectively.
LSG after LAGB yields a positive outcome with higher complication rates than for primary LSG. We advocate this procedure as a good bariatric option for failed LAGB.
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Ogden CL, Carroll MD, Curtin LR, et al. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006;295(13):1549–55.
Shields M, Tjepkema M. Trends in adult obesity. Health Rep. 2006;17(3):53–9.
Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625–38.
Sjöström L, Lindroos AK, Peltonen M, et al. Swedish Obese Subjects Study Scientific Group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.
Shi X, Karmali S, Sharma AM, et al. A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010;20(8):1171–7.
Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17(10):1297305.
Peterli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial. Obes Surg. 2012;22(5):740–8.
Ren CJ, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg. 2000;10(6):514–23. discussion 524. PMID: 11175958.
Agrawal S, Van Dessel E, Akin F, et al. Laparoscopic adjustable banded sleeve gastrectomy as a primary procedure for the super-super obese (body mass index > 60 kg/m2). Obes Surg. 2010;20(8):1161–3.
Gagner M, Gumbs AA. Gastric banding: conversion to sleeve, bypass, or DS. Surg Endosc. 2007;21(11):1931–5.
Spivak H, Abdelmelek MF, Beltran, OR et al. Long-term outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in the United States. Surg Endosc. 2012 Jan 5.PMID: 22219011
Nguyen NT, Slone JA, Nguyen XM, et al. A prospective randomized trial of laparoscopic gastric bypass versus laparoscopic adjustable gastric banding for the treatment of morbid obesity: outcomes, quality of life, and costs. Ann Surg. 2009;250(4):631–41.
Lewis MC, Phillips ML, Slavotinek JP, et al. Change in liver size and fat content after treatment with Optifast very low calorie diet. Obes Surg. 2006;16(6):697–701.
Jacobs M, Gomez E, Romero R, et al. Failed restrictive surgery: is sleeve gastrectomy a good revisional procedure? Obes Surg. 2011;21(2):157–60.
Chevallier JM, Zinzindohoué F, Douard R, et al. Complications after laparoscopic adjustable gastric banding for morbid obesity: experience with 1,000 patients over 7 years. Obes Surg. 2004;14(3):407–14.
Peterli R, Wölnerhanssen BK, Peters T, et al. Prospective study of a two-stage operative concept in the treatment of morbid obesity: primary lap-band followed if needed by sleeve gastrectomy with duodenal switch. Obes Surg. 2007;17(3):334–40.
Abu-Gazala S, Keidar A. Conversion of failed gastric banding into four different bariatric procedures. Surg Obes Relat Dis. 2011 Jun 30; PMID: 21937286
Berende CA, de Zoete JP, Smulders JF, et al. Laparoscopic sleeve gastrectomy feasible for bariatric revision surgery. Obes Surg. 2012;22(2):330–4.
Foletto M, Prevedello L, Bernante P, et al. Sleeve gastrectomy as revisional procedure for failed gastric banding or gastroplasty. Surg Obes Relat Dis. 2010;6(2):146–51.
Csendes A, Braghetto I, León P, et al. Management of leaks after laparoscopic sleeve gastrectomy in patients with obesity. J Gastrointest Surg. 2010;14(9):1343–8.
Deitel M, Gagner M, Erickson AL, et al. Third International Summit: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2011;7(6):749–59. PMID: 21945699.
Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20(5):535–40.
Papailiou J, Albanopoulos K, Toutouzas KG, et al. Morbid obesity and sleeve gastrectomy: how does it work? Obes Surg. 2010;20(10):1448–55.
Vidal J, Ibarzabal A, Romero F, et al. Type 2 diabetes mellitus and the metabolic syndrome following sleeve gastrectomy in severely obese subjects. Obes Surg. 2008;18(9):1077–82.
Goitein D, Feigin A, Segal-Lieberman G, et al. Laparoscopic sleeve gastrectomy as a revisional option after gastric band failure. Surg Endosc. 2011;25(8):2626–30.
Dapri G, Cadière GB, Himpens J. Feasibility and technique of laparoscopic conversion of adjustable gastric banding to sleeve gastrectomy. Surg Obes Relat Dis. 2009;5(1):72–6. PMID: 19161936.
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Yazbek, T., Safa, N., Denis, R. et al. Laparoscopic Sleeve Gastrectomy (LSG)—A Good Bariatric Option for Failed Laparoscopic Adjustable Gastric Banding (LAGB): A Review of 90 Patients. OBES SURG 23, 300–305 (2013). https://doi.org/10.1007/s11695-012-0825-7
- Bariatric surgery
- Morbid obesity
- Laparoscopic sleeve gastrectomy (LSG)
- Laparoscopic Roux-en-Y gastric bypass (LRYGB)
- Laparoscopic adjustable gastric banding (LAGB)