Advertisement

Obesity Surgery

, Volume 24, Issue 10, pp 1808–1811 | Cite as

Conversional Surgery: Single-Step Conversion of Laparoscopic Adjustable Gastric Band to Laparoscopic Sleeve Gastrectomy

  • N. Al Sharqawi
  • S. Al SabahEmail author
  • A. Al Mulla
  • K. Al Anezi
  • T. Jumaa
Other

Abstract

Background

Although some patients attain good outcomes after adjustable gastric band (LAGB), a certain quantity have experienced complications and insufficient weight loss. The objective of this study is to assess the safety and outcome of laparoscopic sleeve gastrectomy (LSG) as a conversion surgery after a failed LAGB.

Methods

This is a retrospective analysis of 40 patients who received LSG as conversional surgery from 2009 to 2012 in Al Amiri Hospital, Kuwait. Data analyzed included percentage of excessive weight loss (EWL%), body mass index (BMI), and postoperative complications. Paired t test was utilized to evaluate total weight loss after both procedures.

Results

Among the 40 patients that underwent conversion surgery, the mean age was 36 years old, 34 (85 %) of which were females. Follow-up for LAGB was 1 to 11 years (median, 4.5 years) and 6 months to 3 years (median, 1 year) for LSG. Mean BMI before LAGB was 44 kg/m2 (SD = 7.2) and mean weight was 117.2 kg (SD = 25.1). A percentage of 20 % achieved good outcomes and 7.5 % experienced complications and 60 % insufficient weight loss. Median EWL% achieved with LAGB was 11.5 %, and after LSG, a median EWL% of 56.9 % was recorded. After conversional surgery, a significant drop in BMI was noted with p value < 0.002.

Conclusions

Laparoscopic conversion from LAGB to LSG may be considered as an alternative for patients with a failed LAGB procedure. However, a longer follow-up study is required to validate the results.

Keywords

Obesity Band Sleeve Revisional Kuwait Bariatric 

Notes

Acknowledgments

The authors would like to convey their humble thanks to all those who made this study possible, most notably Dr. Luqman Thalib, Department of Community Medicine, Faculty of Medicine, Kuwait University; Mr. Jonathan D. Vaz, Dasman Institute, Ms. Reena Thomas; and Mr. Joseph Gomez, Department of Community Medicine, Faculty of Medicine, Kuwait University.

Conflict of Interest

The authors declare that there are no conflicts of interest in this study.

References

  1. 1.
    Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRefGoogle Scholar
  2. 2.
    O’Brien PE, Dixon JB. Lap-band: outcomes and results. J Laparoendosc Adv Surg Tech A. 2003;13(4):265–70.PubMedCrossRefGoogle Scholar
  3. 3.
    Suter M, Calmes JM, Paroz A, et al. A 10 year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg. 2006;16(7):829–35.PubMedCrossRefGoogle Scholar
  4. 4.
    Cottam D, Qureshi FG, Schauer P. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.PubMedCrossRefGoogle Scholar
  5. 5.
    Bernante P, Foletto M, Busetto L. Feasibility of laparoscopic sleeve gastrectomy as a conversion procedure for prior laparoscopic gastric banding. Obes Surg. 2006;16:1327–30.PubMedCrossRefGoogle Scholar
  6. 6.
    Almazeedi S, Al Sabah S, Alshammari D. Routine trans-abdominal ultrasound before laparoscopic sleeve gastrectomy. Obes Surg. 2013. doi: 10.1007/s11695-013-1092-y.
  7. 7.
    Gagner M, Gumbs A. Gastric banding: conversion to sleeve, bypass, or DS. Surg Endosc. 2007;21(11):1931–5.PubMedCrossRefGoogle Scholar
  8. 8.
    Belachew M, Jacqet P, Lardinois F, Karler C. Vertical banded gastrosplasty vs adjustable silicone gastric banding in the treatment of morbid obesity: a preliminary report. Obes Surg. 1993;3(3):275–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Weiner R, Blanco-Engert R, Weiner S, Motkowitz R, Schaefer L, Pomhoff I. Outcome after laparoscopic adjustable gastric banding: 8 years experience. Obes Surg. 2003;13(3):427–34.PubMedCrossRefGoogle Scholar
  10. 10.
    Tucker O, Sucandy I, Szomstein S, Rosenthal RJ. Conversional surgery after failed adjustable gastric banding. Surg Obes Relat Dis. 2008;4(6):740–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Roa PE, Kaider-Person O, Rosenthal RJ, et al. Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obes Surg. 2006;16:1323–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450–6.PubMedCrossRefGoogle Scholar
  13. 13.
    Frezza EE, Jaramillo-de la Torre EJ, Enriquez CC, et al. Laparoscopic sleeve gastrectomy after gastric banding removal: a feasibility study. Surgical Innovation. 2009;16:68–72.PubMedCrossRefGoogle Scholar
  14. 14.
    Deitel M, Crosby R, Gagner M. The first international consensus summit for sleeve gastrectomy. Obes Surg. 2008;18:487–96.PubMedCrossRefGoogle Scholar
  15. 15.
    Acholonu E, McBean E, Court I, et al. Safety and short-term outcomes of laparoscopic sleeve gastrectomy as a conversional approach for failed laparoscopic adjustable gastric banding in the treatment of morbid obesity. Obes Surg. 2009;19:1612–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Marin-Perez P, Betancourt A, Lamota M, et al. Outcomes after laparoscopic conversion of failed adjustable gastric banding to sleeve gastrectomy or Roux-en-Y gastric bypass. Br J Surg. 2014;101(3):254–60.PubMedCrossRefGoogle Scholar
  17. 17.
    Coblijn UK, Verveld CJ, Van Wagensveld BA, Lagarde SM. Laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy as revisional procedure after adjustable gastric band—a systematic review. Obes Surg. 2013;23(11):1899–914.PubMedCrossRefGoogle Scholar
  18. 18.
    Moon RC, Teixeira AF, Jawad MA. Conversion of failed laparoscopic adjustable gastric banding: sleeve gastrectomy or Roux-en-Y gastric bypass? Surg Obes Relat Dis. 2013;9(6):901–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Khan OA, Mansour S, Irukulla S, Reddy KM, Vasilikostas G, Wan AC. Sleeve gastrectomy for gastric band failures—a prospective study. Int J Surg. 2013;11(5):407–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Berende CA, de Zoete JP, Smulders JF, Nienhuijs SW. Laparoscopic sleeve gastrectomy feasible for bariatric revision surgery. Obes Surg. 2012;22(2):330–4.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Zingg U, McQuinn A, DiValentino D, Kinsey-Trotman S, Game P, Watson D. Revisional vs. primary Roux-en-Y gastric bypass—a case-matched analysis: less weight loss in revisions. Obes Surg. 2010;20(12):1627–32.PubMedCrossRefGoogle Scholar
  22. 22.
    Yazbek T, Safa N, Denis R, Atlas H, Garneau PY. Laparoscopic sleeve gastrectomy (LSG)—a good bariatric option for failed laparoscopic adjustable gastric banding (LAGB): a review of 90 patients. Obes Surg. 2013;23(3):300.PubMedCrossRefGoogle Scholar
  23. 23.
    Márquez MF, Ayza MF, Lozano RB, Morales M, Díez JM, et al. Gastric leak after laparoscopic—sleeve gastrectomy for obesity. Obes Surg. 2010;20:1306–11.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • N. Al Sharqawi
    • 1
  • S. Al Sabah
    • 1
    Email author
  • A. Al Mulla
    • 1
  • K. Al Anezi
    • 1
  • T. Jumaa
    • 1
  1. 1.Department of SurgeryAl Amiri HospitalKuwait CityKuwait

Personalised recommendations