Skip to main content

Advertisement

SpringerLink
Log in

Single Anastomosis Gastric Bypass—Comparative Short-Term Outcome Study of Conversional and Primary Procedures

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Single anastomosis gastric bypass (SAGB) has been established as a safe and effective bariatric procedure. SAGB has also been suggested as a conversion option from other procedures, but so far not extensively explored in that direction.

Methods

The study retrospectively reviewed and analyzed 154 consecutive SAGB procedures, including 48 conversional SAGB (cSAGB) and 106 primary SAGB (pSAGB). Preoperative physical dimensions and perioperative complications were obtained. Patients were followed 1, 3, and 6 months postoperatively, with weight measurements compared between groups.

Results

Operative times were longer in the cSAGB group but length of hospital stay was the same for both groups. Sixty-five percent of the cSAGB group had adjustable banding as a primary operation, and 94 % opted for conversion due to insufficient weight loss or regain thereof. Follow-up data availability was 98, 82, and 79 % for the three checkpoints. Three and 6 months postoperatively, cSAGB had inferior mean excess weight loss (EWL) compared to pSAGB, though both groups were successful after 6 months (mean EWL >50 %). Body mass index loss was significantly higher for pSAGB for the first postoperative 3 months. Low complication rates in both groups precluded statistical comparison in that respect.

Discussion

Initial weight loss after conversional SAGB is inferior to primary SAGB after 6 months. The observed safety of cSAGB is comparable to previous evidence for this procedure in the conversional settings.

Conclusion

SAGB may be considered as a safe and effective conversional procedure, but not as effective as pSAGB for initial weight loss.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Patel S, Szomstein S, Rosenthal RJ. Reasons and outcomes of reoperative bariatric surgery for failed and complicated procedures (excluding adjustable gastric banding). Obes Surg. 2011;21(8):1209–19.

    Article  PubMed  Google Scholar 

  2. Nesset, E.M., et al., A two-decade spectrum of revisional bariatric surgery at a tertiary referral center. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery, 2007.3(1): p. 25–30; discussion 30.

  3. Gagner M et al. Laparoscopic reoperative bariatric surgery: experience from 27 consecutive patients. Obes Surg. 2002;12(2):254–60.

    Article  PubMed  Google Scholar 

  4. Inabnet III WB et al. Comparison of 30-day outcomes after non-LapBand primary and revisional bariatric surgical procedures from the Longitudinal Assessment of Bariatric Surgery study. Surgery for obesity and related diseases: official journal of the American Society for bariatric. Surgery. 2010;6(1):22–30.

    Google Scholar 

  5. Spyropoulos C et al. Revisional bariatric surgery: 13-year experience from a tertiary institution. Archives of surgery. 2010;145(2):173–7.

  6. Cariani S et al. Complications after gastroplasty and gastric bypass as a primary operation and as a reoperation. Obes Surg. 2001;11(4):487–90.

    Article  CAS  PubMed  Google Scholar 

  7. Cadiere GB et al. Are laparoscopic gastric bypass after gastroplasty and primary laparoscopic gastric bypass similar in terms of results? Obes Surg. 2011;21(6):692–8.

    Article  PubMed  Google Scholar 

  8. Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15(9):1304–8.

    Article  PubMed  Google Scholar 

  9. Georgiadou D et al. Efficacy and safety of laparoscopic mini gastric bypass. A systematic review. Surgery for obesity and related diseases: official journal of the American Society for Bariatric. Surgery. 2014;10(5):984–91.

    Google Scholar 

  10. Wang W et al. Laparoscopic mini-gastric bypass for failed vertical banded gastroplasty. Obes Surg. 2004;14(6):777–82.

    Article  PubMed  Google Scholar 

  11. Noun R et al. Mini-gastric bypass for revision of failed primary restrictive procedures: a valuable option. Obes Surg. 2007;17(5):684–8.

    Article  PubMed  Google Scholar 

  12. Rutledge R. Revision of failed gastric banding to mini-gastric bypass. Obes Surg. 2006;16(4):521–3.

    Article  PubMed  Google Scholar 

  13. Piazza L et al. Revision of failed primary adjustable gastric banding to mini-gastric bypass: results in 48 consecutive patients. Updat Surg. 2015;67(4):433–7.

    Article  Google Scholar 

  14. Bruzzi, M., et al., Revisional single-anastomosis gastric bypass for a failed restrictive procedure: 5-year results. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery, 2015.

  15. Noun R et al. One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg. 2012;22(5):697–703.

    Article  PubMed  Google Scholar 

  16. Zingg U et al. Revisional vs. primary Roux-en-Y gastric bypass—a case-matched analysis: less weight loss in revisions. Obes Surg. 2010;20(12):1627–32.

    Article  PubMed  Google Scholar 

  17. Goitein D et al. Laparoscopic sleeve gastrectomy as a revisional option after gastric band failure. Surg Endosc. 2011;25(8):2626–30.

    Article  PubMed  Google Scholar 

  18. te Riele WW et al. Conversion of failed laparoscopic gastric banding to gastric bypass as safe and effective as primary gastric bypass in morbidly obese patients. Surgery for obesity and related diseases: official journal of the American Society for Bariatric. Surgery. 2008;4(6):735–9.

    Google Scholar 

  19. Chevallier JM et al. One thousand single anastomosis (omega loop) gastric bypasses to treat morbid obesity in a 7-year period: outcomes show few complications and good efficacy. Obes Surg. 2015;25(6):951–8.

    Article  PubMed  Google Scholar 

  20. Manning S et al. Age- and sex-specific effects on weight loss outcomes in a comparison of sleeve gastrectomy and Roux-en-Y gastric bypass: a retrospective cohort study. BMC obesity. 2014;1:12.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Genser, L., et al., Presentation and surgical management of leaks after mini-gastric bypass for morbid obesity. Surg Obes Relat Dis: Off J Am Soc Bariatric Surg, 2015.

  22. Chang SH et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014;149(3):275–87.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Jacobsen HJ et al. Management of suspected anastomotic leak after bariatric laparoscopic Roux-en-y gastric bypass. Br J Surg. 2014;101(4):417–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Vasas P et al. Short- and long-term outcomes of vertical banded gastroplasty converted to Roux-en-Y gastric bypass. Obes Surg. 2013;23(2):241–8.

    Article  PubMed  Google Scholar 

  25. Kellogg TA. Revisional bariatric surgery. Surg Clin North Am. 2011;91(6):1353–71 .x

    Article  PubMed  Google Scholar 

  26. Brolin RE, Cody RP. Weight loss outcome of revisional bariatric operations varies according to the primary procedure. Ann Surg. 2008;248(2):227–32.

    Article  PubMed  Google Scholar 

  27. Tucker O et al. Revisional surgery after failed laparoscopic adjustable gastric banding. Surg Obes Relat Dis: Off J Am Soc Bariatric Surg. 2008;4(6):740–7.

    Article  Google Scholar 

  28. Acholonu E et al. Safety and short-term outcomes of laparoscopic sleeve gastrectomy as a revisional approach for failed laparoscopic adjustable gastric banding in the treatment of morbid obesity. Obes Surg. 2009;19(12):1612–6.

    Article  PubMed  Google Scholar 

  29. Fronza JS et al. Revisional bariatric surgery at a single institution. Am J Surg. 2010;200(5):651–4.

    Article  PubMed  Google Scholar 

  30. Kuesters S et al. Revisionary bariatric surgery: indications and outcome of 100 consecutive operations at a single center. Surg Endosc. 2012;26(6):1718–23.

    Article  PubMed  Google Scholar 

  31. Mahawar KK et al. “Mini” gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013;23(11):1890–8.

    Article  PubMed  Google Scholar 

  32. Swartz DE, Mobley E, Felix EL. Bile reflux after Roux-en-Y gastric bypass: an unrecognized cause of postoperative pain. Surg Obes Relat Dis: Off J Am Soc Bariatric Surg. 2009;5(1):27–30.

    Article  Google Scholar 

Download references

Acknowledgments

We have no acknowledgements to declare for this article.

Author information

Authors and Affiliations

  1. Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel

    Chanan Meydan, Asnat Raziel, Nasser Sakran, Varda Gottfried & David Goitein

  2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Chanan Meydan

  3. Department of Surgery A, Emek Medical Center, Afula, Israel, affiliated with Rappaport, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    Nasser Sakran

  4. Department of Surgery C, Tel Hashomer Medical Center, Ramat Gan, Israel, affiliated with, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    David Goitein

Authors
  1. Chanan Meydan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Asnat Raziel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nasser Sakran
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Varda Gottfried
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. David Goitein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Goitein.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Statement

This is a retrospective type of study; thus, formal consent is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Funding

No funding was granted for this study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Meydan, C., Raziel, A., Sakran, N. et al. Single Anastomosis Gastric Bypass—Comparative Short-Term Outcome Study of Conversional and Primary Procedures. OBES SURG 27, 432–438 (2017). https://doi.org/10.1007/s11695-016-2336-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-016-2336-4

Keywords

Search

Navigation