Skip to main content

Advertisement

SpringerLink
Log in

Conversion of both Versions of Vertical Banded Gastroplasty to Laparoscopic Roux-en-Y Gastric Bypass: Analysis of Short-term Outcomes

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

Abstract

Background

Conversional bariatric surgery has relatively high rates of complications. We aimed to analyze our single-center experience with patients requiring conversional laparoscopic Roux-en-Y gastric bypass (LRYGB) following a failed primary open or laparoscopic vertical banded gastroplasty (OVBG or LVBG, respectively).

Methods

The records of patients who underwent LRYGB as a conversional procedure after VBG between November 2004 and December 2017 were reviewed. Characteristics, body mass index (BMI), operation time, intraoperative problems, length of hospitalization, and early (< 30 days) morbidity and mortality were analyzed. Data were expressed as mean ± standard deviation or frequency.

Results

A total of 329 patients (81.76% females) who underwent conversional RYGB were included. For the LVBG group (224 patients) and OVBG group (105 patients), respectively, BMI was 34.15 ± 6.38 and 37.79 ± 6.31 kg/m2 (p < 0.05), the operation time was 96.00 ± 31.40 and 123.15 ± 40.26 min (p < 0.05), hospitalization duration was 2.96 ± 1.13 and 3.20 ± 1.20 days (p = 0.08), the early complication rate was 7.14 and 11.43% (p = 0.19), and the reoperation rate was 2.23 and 2.86% (p = 0.73). There were no major intraoperative problems. Three patients with OVBG were converted to open RYGB (2.86%). There was no mortality.

Conclusion

The conversion of OVBG and LVBG to laparoscopic RYGB is technically feasible and provides comparably low early morbidity rates and length of hospitalization. However, compared to LVBG, conversional laparoscopic RYGB following OVBG is technically more challenging and time-consuming, with a slightly higher risk of conversion to open surgery. We support the use of such conversional bariatric surgery in specialized, high-volume bariatric centers.

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

Similar content being viewed by others

References

  1. World Health Organization. Obesity and overweight: fact sheet. 2018; Available from: http://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. February 2018; Accessed July 2018.

  2. Gloy VL, Briel M, Bhatt DL, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:F934.

    Article  Google Scholar 

  3. Mason EE. Vertical banded gastroplasty for obesity. Arch Surg. 1982;117(5):701–6.

    Article  CAS  PubMed  Google Scholar 

  4. Marsk R, Jonas E, Gartzios H, et al. High revision rates after laparoscopic vertical banded gastroplasty. Surg Obes Relat Dis. 2009;5(1):94–8.

    Article  PubMed  Google Scholar 

  5. Schouten R, Wiryasaputra DC, van Dielen FM, et al. Long-term results of bariatric restrictive procedures: a prospective study. Obes Surg. 2010;20(12):1617–26.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Mason EE, Doherty C. Vertical banded gastroplasty for morbid obesity. Dig Surg. 1997;14(5):355–60.

    Article  Google Scholar 

  7. MacLean LD, Rhode BM, Forse RA. A gastroplasty that avoids stapling in continuity. Surgery. 1993;113(4):380–8.

    CAS  PubMed  Google Scholar 

  8. Nocca D, Aggarwal R, Blanc P, et al. Laparoscopic vertical banded gastroplasty. Surg Endosc. 2007;21(6):870–4.

    Article  CAS  PubMed  Google Scholar 

  9. del Amo DA, Diez MM, Guedea ME, et al. Vertical banded gastroplasty: is it a durable operation for morbid obesity? Obes Surg. 2004;14(4):536–8.

    Article  PubMed  Google Scholar 

  10. Tevis S, Garren MJ, Gould JC. Revisional surgery for failed vertical-banded gastroplasty. Obes Surg. 2011;21(8):1220–4.

    Article  PubMed  Google Scholar 

  11. Schouten R, van Dielen FM, van Gemert WG, et al. Conversion of vertical banded gastroplasty to Roux-en-Y gastric bypass results in restoration of the positive effect on weight loss and co-morbidities: evaluation of 101 patients. Obes Surg. 2007;17(5):622–30.

    Article  PubMed  PubMed Central  Google Scholar 

  12. van Wezenbeek MR, Smulders JF, de Zoete JP, et al. Long-term results of primary vertical banded gastroplasty. Obes Surg. 2015;25(8):1425–30.

    Article  PubMed  Google Scholar 

  13. Miller K, Pump A, Hell E. Vertical banded gastroplasty versus adjustable gastric banding: prospective long-term follow-up study. Surg Obes Relat Dis. 2007;3(1):84–90.

    Article  PubMed  Google Scholar 

  14. Scozzari G, Toppino M, Famiglietti F, et al. 10-year follow-up of laparoscopic vertical banded gastroplasty: good results in selected patients. Ann Surg. 2010;252(5):831–9.

    Article  PubMed  Google Scholar 

  15. Gentileschi P, Kini S, Catarci M, et al. Evidence-based medicine: open and laparoscopic bariatric surgery. Surg Endosc. 2002;16(5):736–44.

    Article  CAS  PubMed  Google Scholar 

  16. Yale CE. Conversion surgery for morbid obesity: complications and long-term weight control. Surgery. 1989;106(3):474–80.

    CAS  PubMed  Google Scholar 

  17. Behrns KE, Smith CD, Kelly KA, et al. Reoperative bariatric surgery. Lessons learned to improve patient selection and results. Ann Surg. 1993;218(5):646–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Hunter R, Watts JM, Dunstan R, et al. Revisional surgery for failed gastric restrictive procedures for morbid obesity. Obes Surg. 1992;2(3):245–52.

    Article  CAS  PubMed  Google Scholar 

  19. Capella RF, Capella JF. Converting vertical banded gastroplasty to a lesser curvature gastric bypass: technical considerations. Obes Surg. 1998;8(2):218–24.

    Article  CAS  PubMed  Google Scholar 

  20. American Society for Metabolic and Bariatric Surgery. Bariatric surgery procedures. 2017; Available from: https://asmbs.org/patients/bariatric-surgery-procedures; Accessed 17 May 2017.

  21. Debergh I, Defoort B, de Visschere M, et al. A one-step conversion from gastric banding to laparoscopic Roux-en-Y gastric bypass is as safe as a two-step conversion: a comparative analysis of 885 patients. Acta Chir Belg. 2016;116(5):271–7.

    Article  PubMed  Google Scholar 

  22. Reinhold RB. Critical analysis of long term weight loss following gastric bypass. Surg Gynecol Obstet. 1982;155(3):385–94.

    CAS  PubMed  Google Scholar 

  23. Dillemans B, Deylgat B. LRYGB: the fully stapled technique. In: Agrawal S, editor. Obesity, bariatric and metabolic surgery: a practical guide. Cham: Springer International Publishing; 2016. p. 197–205.

    Chapter  Google Scholar 

  24. Dillemans B, Sakran N, van Cauwenberge S, et al. Standardization of the fully stapled laparoscopic Roux-en-Y gastric bypass for obesity reduces early immediate postoperative morbidity and mortality: a single center study on 2606 patients. Obes Surg. 2009;19(10):1355–64.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Morino M, Toppino M, Garrone C, et al. Laparoscopic adjustable silicone gastric banding for the treatment of morbid obesity. Br J Surg. 1994;81(8):1169–70.

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  27. Buchwald H, Estok R, Fahrbach K, et al. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery. 2007;142(4):621–32. discussion 632-5

    Article  PubMed  Google Scholar 

  28. Hernandez-Estefania R, Gonzalez-Lamuno D, Garcia-Ribes M, et al. Variables affecting BMI evolution at 2 and 5 years after vertical banded gastroplasty. Obes Surg. 2000;10(2):160–6.

    Article  CAS  PubMed  Google Scholar 

  29. Mason EE, Cullen JJ. Management of complications in vertical banded gastroplasty. Curr Surg. 2003;60(1):33–7.

    Article  PubMed  Google Scholar 

  30. Weber M, Muller MK, Michel JM, et al. Laparoscopic Roux-en-Y gastric bypass, but not rebanding, should be proposed as rescue procedure for patients with failed laparoscopic gastric banding. Ann Surg. 2003;238(6):827–33. discussion 833-4

    Article  PubMed  PubMed Central  Google Scholar 

  31. Berende CAS, de Zoete JP, Smulders JF, et al. Laparoscopic sleeve gastrectomy feasible for bariatric revision surgery. Obes Surg. 2012;22(2):330–4.

    Article  PubMed  Google Scholar 

  32. 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.

    Article  PubMed  Google Scholar 

  33. Iannelli A, Schneck AS, Ragot E, et al. Laparoscopic sleeve gastrectomy as revisional procedure for failed gastric banding and vertical banded gastroplasty. Obes Surg. 2009;19(9):1216–20.

    Article  PubMed  Google Scholar 

  34. Genco A, Soricelli E, Casella G, et al. Gastroesophageal reflux disease and Barrett’s esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication. Surg Obes Relat Dis. 2017;13(4):568–74.

    Article  PubMed  Google Scholar 

  35. Germanova D, Loi P, van Vyve E, et al. Previous bariatric surgery increases postoperative morbidity after sleeve gastrectomy for morbid obesity. Acta Chir Belg. 2013;113(4):254–7.

    Article  CAS  PubMed  Google Scholar 

  36. Gumbs AA, Pomp A, Gagner M. Revisional bariatric surgery for inadequate weight loss. Obes Surg. 2007;17(9):1137–45.

    Article  PubMed  Google Scholar 

  37. Abu-Gazala S, Sadot E, Maler I, et al. Laparoscopic conversion of failed silastic ring vertical gastroplasty (SRVG) and vertical banded gastroplasty (VBG) into biliopancreatic diversion (BPD). J Gastrointest Surg. 2015;19(4):625–30.

    Article  PubMed  Google Scholar 

  38. Gagner M, Gentileschi P, de Csepel J, et al. Laparoscopic reoperative bariatric surgery: experience from 27 consecutive patients. Obes Surg. 2002;12(2):254–60.

    Article  PubMed  Google Scholar 

  39. Gagne DJ, Dovec E, Urbandt JE. Laparoscopic revision of vertical banded gastroplasty to Roux-en-Y gastric bypass: outcomes of 105 patients. Surg Obes Relat Dis. 2011;7(4):493–9.

    Article  PubMed  Google Scholar 

  40. Cohen R, Pinheiro JS, Correa JL, et al. Laparoscopic revisional bariatric surgery: myths and facts. Surg Endosc. 2005;19(6):822–5.

    Article  CAS  PubMed  Google Scholar 

  41. Suter M, Ralea S, Millo P, et al. Laparoscopic Roux-en-Y gastric bypass after failed vertical banded gastroplasty: a multicenter experience with 203 patients. Obes Surg. 2012;22(10):1554–61.

    Article  CAS  PubMed  Google Scholar 

  42. Sanchez H, Cabrera A, Cabrera K, et al. Laparoscopic Roux-en-Y gastric bypass as a revision procedure after restrictive bariatric surgery. Obes Surg. 2008;18(12):1539–43.

    Article  PubMed  Google Scholar 

  43. Apers JA, Wens C, van Vlodrop V, et al. Perioperative outcomes of revisional laparoscopic gastric bypass after failed adjustable gastric banding and after vertical banded gastroplasty: experience with 107 cases and subgroup analysis. Surg Endosc. 2013;27(2):558–64.

    Article  CAS  PubMed  Google Scholar 

  44. Gonzalez R, Gallagher SF, Haines K, et al. Operative technique for converting a failed vertical banded gastroplasty to Roux-en-Y gastric bypass. J Am Coll Surg. 2005;201(3):366–74.

    Article  PubMed  Google Scholar 

  45. Cadiere GB, Himpens J, Bazi M, 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 

  46. Begg DP, Woods SC. The endocrinology of food intake. Nat Rev Endocrinol. 2013;9(10):584–97.

    Article  CAS  PubMed  Google Scholar 

  47. David MB, Abu-Gazala S, Sadot E, et al. Laparoscopic conversion of failed vertical banded gastroplasty to Roux-en-Y gastric bypass or biliopancreatic diversion. Surg Obes Relat Dis. 2015;11(5):1085–91.

    Article  PubMed  Google Scholar 

  48. Gys B, Haenen F, Ruyssers M, et al. Conversion of open vertical banded gastroplasty to Roux-en-Y gastric bypass: a single-center, single-surgeon experience with 6 years of follow-up. Obes Surg. 2016;26(4):805–9.

    Article  PubMed  Google Scholar 

  49. van Wezenbeek MR, Smulders FJ, de Zoete JP, et al. Long-term results after revisions of failed primary vertical banded gastroplasty. World J Gastrointest Surg. 2016;8(3):238–45.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, AZ Sint-Jan Brugge-Oostende AV, Campus Sint-Jan, Ruddershove 10, 8000, Bruges, Belgium

    Talal Khewater, Nathalie Yercovich, Isabelle Debergh & Bruno Dillemans

  2. Student at Faculty of Medicine, KU Leuven University, Herestraat 49, 3000, Leuven, Belgium

    Edouard Grymonprez

Authors
  1. Talal Khewater
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nathalie Yercovich
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Edouard Grymonprez
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Isabelle Debergh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bruno Dillemans
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Talal Khewater.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest or financial ties to disclose.

Informed Consent

Informed consent was obtained from all individual participants included in this study prior to the conversional procedures to have their data used anonymously for academic purposes.

Ethical Approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Furthermore, the local ethics committee of our hospital had approved this study protocol.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Khewater, T., Yercovich, N., Grymonprez, E. et al. Conversion of both Versions of Vertical Banded Gastroplasty to Laparoscopic Roux-en-Y Gastric Bypass: Analysis of Short-term Outcomes. OBES SURG 29, 1797–1804 (2019). https://doi.org/10.1007/s11695-019-03768-w

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-019-03768-w

Keywords

Search

Navigation