Outcomes After Laparoscopic Conversion of Failed Adjustable Gastric Banding (LAGB) to Laparoscopic Sleeve Gastrectomy (LSG) or Single Anastomosis Duodenal Switch (SADS)



Inadequate weight loss following LAGB (laparoscopic adjusted gastric banding) requiring band removal and conversion to another bariatric procedure is common. There is a paucity of objective data to guide procedure selection. Single anastomosis modifications (SIPS, SADI, SADS) of the duodenal switch biliopancreatic division (DS-BPD) are being investigated. Laparoscopic sleeve gastrectomy (LSG) has become the most prevalent primary bariatric procedure and has been used for revision following LAGB.


The purpose is to investigate single-stage LAGB removal to LSG SADS (single anastomosis duodenal switch). A matched cohort analysis compared each revision to a similar patient having a primary procedure. This was performed to understand the impact of prior banding on outcomes with each procedure.

Materials and Methods

This is a retrospective study to investigate the outcomes of revision of LAGB for inadequate weight loss to LSG or SADS. To determine whether prior banding impairs results, a matched cohort was done comparing each revision to a patient that had a primary procedure.


As expected, patients who had SADS had greater weight loss than LSG. There was no difference in peri-operative and early complications. Both procedures resulted in weight loss. Importantly, with matched cohort, prior LAGB decreased weight loss outcomes in LSG, but not SADS.


Conversion of LAGB to LSG or SADS results in weight loss. The presence of LAGB decreases weight loss in LSG, but not in SADS. This can have important implications for long-term outcomes.

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Change history

  • 07 March 2019

    In the original article the Conflict of Interest statement was incomplete. Dr. Roslin discloses that he is a teaching consultant for Ethicon and Medtronics. He also has received research funding from Medtronics.


  1. 1.

    Angrisani et al. IFSO Worldwide Survey 2016: primary, endoluminal and revisional procedures. Obes Surg. 2018 Dec;28(12):3783–94. https://doi.org/10.1007/s11695-018-3450-2.

    Article  PubMed  PubMed Central  Google Scholar 

  2. 2.

    Roslin et al; Stomach intestinal pyloric sparing surgery or SIPS; current surgery report, 2016. doi:https://doi.org/10.1007/s40137-016-0157-y, 4.

  3. 3.

    Abraham A, Ikramuddin S, Jahansouz C, et al. Trends in bariatric surgery: procedure selection, revisional surgeries, and readmissions. Obes Surg. 2016 Jul;26(7):1371–7.

    Article  Google Scholar 

  4. 4.

    Kularatna M et al. Weight regain following sleeve gastrectomy—a systematic review. Obes Surg. 2016;26:1326–34. https://doi.org/10.1007/s11695-016-2152-x.

    Article  PubMed  Google Scholar 

  5. 5.

    Sanchez A et al. Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) for obese diabetic patients. Surg Obes Relat Dis. 2015;11:1092–8. https://doi.org/10.1016/j.soard.2015.01.024.

    Article  Google Scholar 

  6. 6.

    Topart P; The single anastomosis duodenal switch modifications: a review of the current literature on outcomes. doi: https://doi.org/10.1016/j.soard.2017.04.027.

    Article  Google Scholar 

  7. 7.

    Kindel T, Martin E, Hungness E, et al. High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surg Obes Relat Dis. 2014;10(6):1070–5.

    Article  Google Scholar 

  8. 8.

    Aarts EO, Dogan K, Koehestanie P, et al. What happens after gastric band removal without additional bariatric surgery? Surg Obes Relat Dis. 2014;10(6):1092–6.

    Article  Google Scholar 

  9. 9.

    Carr WR, Jennings NA, Boyle M, et al. A retrospective comparison of early results of conversion of failed gastric banding to sleeve gastrectomy or gastric bypass. Surg Obes Relat Dis. 2015;11(2):379–84.

    Article  Google Scholar 

  10. 10.

    Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.

    CAS  Article  Google Scholar 

  11. 11.

    Marceau P, Biron S, Hould FS, et al. Duodenal switch: long-term results. Obes Surg. 2007;17(11):1421–30.

    Article  Google Scholar 

  12. 12.

    Poyck PP, Polat F, Gouma DJ, et al. Is biliopancreatic diversion with duodenal switch a solution for patients after laparoscopic gastric banding failure? Surg Obes Relat Dis. 2012;8(4):393–9.

    CAS  Article  Google Scholar 

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Correspondence to Ali Shayesteh.

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Pearlstein, S., Sabrudin, S.A., Shayesteh, A. et al. Outcomes After Laparoscopic Conversion of Failed Adjustable Gastric Banding (LAGB) to Laparoscopic Sleeve Gastrectomy (LSG) or Single Anastomosis Duodenal Switch (SADS). OBES SURG 29, 1726–1733 (2019). https://doi.org/10.1007/s11695-019-03729-3

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  • Laparoscopic adjustable gastric banding (LAGB)
  • Failed/revision LAGB
  • Single anastomosis duodenal switch
  • Laparoscopic vertical sleeve gastrectomy
  • Nutrition
  • Outcome of revision LAGB