Conversion of Failed Vertical Banded Gastroplasty to Open Adjustable Gastric Banding

Background: Occasionally, patients with failed vertical banded gastroplasty (VBG) present for secondary treatment. We performed the reoperations using adjustable gastric banding (AGB) technique. Methods: From 1991 to 1997, 80 morbidly obese patients underwent VBG. In 7 (8.7%), staple-line disruption and weight regain were detected within 2 years of follow-up. Conversion to AGB was performed between 1994 and 1998. Meanwhile, another 80 morbidly obese patients underwent primary open AGB. Results: In the 7 patients, staple-line disruption was seen on radiography as a leak of contrast material across the gastric partition. After conversion of "failed" VBGs to AGB, postoperative results have been very satisfactory and similar to those of the primary open AGB group. Conclusions: VBG is a safe technique, although conversion rates were significant. Staple-line disruption constituted the chief cause of insufficient weight loss and frequently indicated the need for further surgery. Our results of the revisional surgery confirm that the reoperations for failed VBG can be performed using AGB technique.