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Revision After Gastric Banding

  • Andres Giovannetti
  • Rami Lutfi
Chapter

Abstract

Laparoscopic adjustable gastric banding (LAGB) was described in 1993 and approved by the FDA to be used in the USA in 2001. It is a purely restrictive procedure designed to confront obesity. By 2010 these operations accounted for 46% of all the bariatric surgeries performed in American College of Surgeons accredited centers [1].

Since its introduction, LAGB placement has been considered as a safe, reversible, and low-risk procedure with promising short-term outcomes as reported by many of the initial studies [2–4]. However, more recent investigations reviewing long-term outcomes showed high rate of reoperation and revision for complications like band erosion, slippage, and gastric pouch enlargement as well as weight loss failure [1, 5–8].

Based on the National Inpatient Sample (NIS) database, between 2005 and 2014, 159,890 morbidly obese individuals underwent LAGB insertion. Utilization of this procedure started with around 14,000 in 2005, peaking in 2008 at 35,000 cases to decrease to 1170 in 2014. Interestingly the number of procedures for removal and revision during the same period increased progressively from a total of 1405 in 2005 to 7240 in 2014 (an increase of 432%) [1].

There are multiple potential reasons for failed weight loss following LAGB. These include complications related to the adjustable gastric band prosthesis, lack of compliance with dietary advice or adjustment regimens, or low resting energy expenditure [5].

In general, AGB have inferior results compared with stapling procedures due to lack of metabolic effect. However, when minimal weight loss or recurrence of obesity occur, a comprehensive evaluation of the patient needs to be done by the team (including dietitian and psychologist) before blaming the AGB. It is our practice to look at the compliance and the number of adjustments done before going forward with further workup.

The current literature shows that up to 60% of patients required revision of the primary surgery between 30 and 80 months after placement, being the most common indication insufficient weight loss [5, 8, 9].

The goal of this chapter is to provide a review of the outcomes after different conversion options available LAGB as well as describe the essential surgical steps during these procedures.

Keywords

Gastric banding Gastric sleeve Sleeve gastrectomy Revisional surgery Gastric bypass Single stage Two stage Morbid obesity Bariatric surgery 

References

  1. 1.
    Rudnicki M, Giovannetti A, Bueltmann K. Have we reached the end of the lifespan of laparoscopic banding for morbid obesity? In: Poster presented at digestive disease week 2017. Chicago; 2017.Google Scholar
  2. 2.
    O’Brien P, et al. Lap-band: outcomes and results. J Laparoendosc Adv Surg Tech. 2003;13(4):265–70.  https://doi.org/10.1089/109264203322333593.CrossRefGoogle Scholar
  3. 3.
    Ren CJ, Horgan S, Ponce J. US experience with the LAP-BAND system. Am J Surg. 2002;184(6):S46–50.  https://doi.org/10.1016/S0002-9610(02)01180-7.CrossRefGoogle Scholar
  4. 4.
    Angrisani L, Alkilani M, Basso N, et al. Laparoscopic Italian experience with the Lap-Band®. Obes Surg. 2001;11(3):307–10.  https://doi.org/10.1381/096089201321336656.CrossRefPubMedGoogle Scholar
  5. 5.
    Smith MD, Patterson E. The ASMBS textbook of bariatric. Surgery. 2014;1:283–93.  https://doi.org/10.1007/978-1-4939-1197-4.CrossRefGoogle Scholar
  6. 6.
    Kowalewski PK, Olszewski R, Kwiatkowski AP, Paśnik K. Revisional bariatric surgery after failed laparoscopic adjustable gastric banding – a single-center, long-term retrospective study. Wideochirurgia i inne Tech maloinwazyjne = Videosurgery Other miniinvasive Tech. 2017;12(1):32–6.  https://doi.org/10.5114/wiitm.2017.66671.CrossRefGoogle Scholar
  7. 7.
    Mendes-Castro A, Montenegro J, Cardoso JF, et al. Laparoscopic adjustable gastric band: complications, removal and revision in a Portuguese highly differentiated obesity treatment center. Acta Med Port. 2015;28(6):735–40.  https://doi.org/10.1007/s11695-016-2348-0.CrossRefPubMedGoogle Scholar
  8. 8.
    Altieri MS, Yang J, Telem DA, et al. Lap band outcomes from 19,221 patients across centers and over a decade within the state of New York. Surg Endosc Other Interv Tech. 2016;30(5):1725–32.  https://doi.org/10.1007/s00464-015-4402-8.CrossRefGoogle Scholar
  9. 9.
    Angrisani L, Vitiello A, Santonicola A, Hasani A, De Luca M, Iovino P. Roux-en-Y gastric bypass versus sleeve gastrectomy as revisional procedures after adjustable gastric band: 5-year outcomes. Obes Surg. 2017;27(6):1430–7.  https://doi.org/10.1007/s11695-016-2502-8.CrossRefPubMedGoogle Scholar
  10. 10.
    Kassir R, Lointier P, Tiffet O, et al. Revision bariatric surgery: what technical choices should be taken depending on the first intervention? Int J Surg. 2017;44:7–8.  https://doi.org/10.1016/j.ijsu.2017.05.075.CrossRefPubMedGoogle Scholar
  11. 11.
    Carr WRJ, Jennings NA, Boyle M, Mahawar K, Balupuri S, Small PK. 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.  https://doi.org/10.1016/j.soard.2014.07.021.CrossRefPubMedGoogle Scholar
  12. 12.
    Marin-Perez P, Betancourt A, Lamota M, Lo Menzo E, Szomstein S, Rosenthal R. 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.  https://doi.org/10.1002/bjs.9344.CrossRefPubMedGoogle Scholar
  13. 13.
    Yeung L, Durkan B, Barrett A, et al. Single-stage revision from gastric band to gastric bypass or sleeve gastrectomy: 6- and 12-month outcomes. Surg Endosc Other Interv Tech. 2016;30(6):2244–50.  https://doi.org/10.1007/s00464-015-4498-x.CrossRefGoogle Scholar
  14. 14.
    Patel S, Eckstein J, Acholonu E, Abu-Jaish W, Szomstein S, Rosenthal RJ. Reasons and outcomes of laparoscopic revisional surgery after laparoscopic adjustable gastric banding for morbid obesity. Surg Obes Relat Dis. 2010;6(4):391–8.  https://doi.org/10.1016/j.soard.2009.12.010.CrossRefPubMedGoogle Scholar
  15. 15.
    Sergio C, Maldonado P, Rivkine E, Valenti A, Polliand C, Barrat C. Revisional surgery after failed laparoscopic adjustable gastric banding. Comparison between roux-en-y gastric bypass and gastric sleeve. Obes Surg. 2013;23(8):1184.Google Scholar
  16. 16.
    Janik MR, Rogula TG, Mustafa RR, Alhaj Saleh A, Khaitan L. Safety of revision sleeve gastrectomy compared to roux-Y gastric bypass after failed gastric banding. Ann Surg. 2017;XX(Xx):1.  https://doi.org/10.1097/SLA.0000000000002559.CrossRefGoogle Scholar
  17. 17.
    Gonzalez-Heredia R, Masrur M, Patton K, Bindal V, Sarvepalli S, Elli E. Revisions after failed gastric band: sleeve gastrectomy and Roux-en-Y gastric bypass. Surg Endosc Other Interv Tech. 2015;29(9):2533–7.  https://doi.org/10.1007/s00464-014-3995-7.CrossRefGoogle Scholar
  18. 18.
    Spaniolas K, Bates AT, Docimo S, Obeid NR, Talamini MA, Pryor AD. Single stage conversion from adjustable gastric banding to sleeve gastrectomy or Roux-en-Y gastric bypass: an analysis of 4875 patients. Surg Obes Relat Dis. 2017;13(11):1880–4.  https://doi.org/10.1016/j.soard.2017.07.014.CrossRefPubMedGoogle Scholar
  19. 19.
    Dang JT, Switzer NJ, Wu J, et al. Gastric band removal in revisional bariatric surgery, one-step versus two-step: a systematic review and meta-analysis. Obes Surg. 2016;26(4):866–73.  https://doi.org/10.1007/s11695-016-2082-7.CrossRefPubMedGoogle Scholar
  20. 20.
    Alqahtani AR, Elahmedi MO, Al Qahtani AR, Yousefan A, Al-Zuhair AR. 5-year outcomes of 1-stage gastric band removal and sleeve gastrectomy. Surg Obes Relat Dis. 2016;12(10):1769–76.  https://doi.org/10.1016/j.soard.2016.05.017.CrossRefPubMedGoogle Scholar
  21. 21.
    Noel P, Schneck AS, Nedelcu M, et al. Laparoscopic sleeve gastrectomy as a revisional procedure for failed gastric banding: lessons from 300 consecutive cases. Surg Obes Relat Dis. 2014;10(6):1116–22.  https://doi.org/10.1016/j.soard.2014.02.045.CrossRefPubMedGoogle Scholar
  22. 22.
    Chansaenroj P, Aung L, Lee WJ, Chen SC, Chen JC, Ser KH. Revision procedures after failed adjustable gastric banding: comparison of efficacy and safety. Obes Surg. 2017;27(11):2861–7.  https://doi.org/10.1007/s11695-017-2716-4.CrossRefPubMedGoogle Scholar
  23. 23.
    Tan MHL, Yee GYW, Jorgensen JO, et al. A histologic evaluation of the laparoscopic adjustable gastric band capsule by tissue sampling during sleeve gastrectomy performed at different time points after band removal. Surg Obes Relat Dis. 2014;10(4):620–5.  https://doi.org/10.1016/j.soard.2014.02.037.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Andres Giovannetti
    • 1
  • Rami Lutfi
    • 2
  1. 1.Department of SurgeryMercy Hospital Medical CenterChicagoUSA
  2. 2.University of Illinois at ChicagoChicagoUSA

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