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Revision of the Laparoscopic Gastric Band

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Revisional Foregut Surgery

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Abstract

The popularity of the laparoscopic adjustable gastric band (LAGB) has seen a significant decline over the past decade. Reasons for this can be appreciated by understanding the two general indications for its removal: failure to maintain adequate long-term weight loss and serious complications due to the band itself. The efficacy of the LAGB in maintaining adequate long-term weight loss has been both refuted and supported. Though some have argued for the band to be a potentially effective weight loss tool, it became increasingly clear that the band was being placed at the expense of significant morbidity, with some cohorts demonstrating complication rates as high as 40–50%. Common complications include port- or catheter-related problems, band leakage, band infection, gastroesophageal reflux disease, and esophagitis. The most concerning complications include gastric pouch dilation, band slippage, and band erosion. As a consequence of its morbidity, surgeons have been forced to become adept at the explantation of these bands, with both minimally invasive and endoscopic techniques having been tried, described, implemented, and popularized. As the band creates a particularly challenging operative field, secondary to gastric and perigastric inflammation and fibrosis, the safety of one-stage versus two-stage revisional procedures have been debated. Regardless, after band removal, standard options for revisional surgery include conversion to either revisional laparoscopic Roux-en-Y gastric bypass or revisional laparoscopic sleeve gastrectomy. As with many clinical situations, an experienced surgeon in conjunction with a patient-tailored treatment plan should maximize the chances of performing a successful revision of the laparoscopic gastric band.

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References

  1. Buchwald H, Buchwald J. Evolution of operative procedures for the management of morbid obesity 1950–2000. Obes Surg. 2002;12(5):705–17. https://doi.org/10.1381/096089202321019747.

    Article  PubMed  Google Scholar 

  2. Singh D, Laya A, Clarkston W, Allen M. Jejunoileal bypass: a surgery of the past and a review of its complications. World J Gastroenterol. 2009;15(18):2277–9.

    Article  Google Scholar 

  3. Eckhout G, Willbanks O, Moore JT. Vertical ring gastroplasty for morbid obesity. Five year experience with 1,463 patients. Am J Surg. 1986;152(6):713–6.

    Article  CAS  Google Scholar 

  4. Printen KJ, Mason EE. Gastric surgery for relief of morbid obesity. Arch Surg. 1973;106(4):428–31. https://doi.org/10.1001/archsurg.1973.01350160046007.

    Article  CAS  Google Scholar 

  5. Celio A, Pories W. A history of bariatric surgery: the maturation of a medical discipline. Surg Clin North Am. 2016;96(4):655–67. https://doi.org/10.1016/j.suc.2016.03.001.

    Article  PubMed  Google Scholar 

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

    Article  CAS  Google Scholar 

  7. Elder KA, Wolfe BM. Bariatric Surgery: a review of procedures and outcomes. Gastroenterology. 2007;132(6):2253–71.

    Article  Google Scholar 

  8. Capella J, Capella R. The weight reduction operation of choice: vertical banded gastroplasty or gastric bypass? Am J Surg. 1996;171(1):74–9. https://doi.org/10.1016/S0002-9610(99)80077-4.

    Article  CAS  PubMed  Google Scholar 

  9. Wilkinson L. Reduction of gastric reservoir capacity. Am J Clin Nutr. 1980;33(2 Suppl):515–7. https://doi.org/10.1093/ajcn/33.2.515.

    Article  CAS  PubMed  Google Scholar 

  10. Kuzmak L. A review of seven years’ experience with silicone gastric banding. Obes Surg. 1991;1(4):403–8. https://doi.org/10.1381/096089291765560809.

    Article  CAS  PubMed  Google Scholar 

  11. Belachew M, Legrand M, Vincent V. History of lap-band: from dream to reality. Obes Surg. 2001;11(3):297–302.

    Article  CAS  Google Scholar 

  12. Belachew M, Legrand V, Vincenti T, et al. Laparoscopic placement of adjustable silicone gastric band in the treatment of morbid obesity: how to do it. Obes Surg. 1995;5(1):66–70.

    Article  CAS  Google Scholar 

  13. Belachew M, Legrand M, Vincent V, Lismonde M, Le Docte N, Deschamps V. Laparoscopic adjustable gastric banding. World J Surg. 1998;22(9):955–63.

    Article  CAS  Google Scholar 

  14. O’Brien P, Brown W, Smith A, McMurrick P, Stephens M. Prospective study of a laparoscopically placed, adjustable gastric band in the treatment of morbid obesity. Br J Surg. 1999;86(1):113–8. https://doi.org/10.1046/j.1365-2168.1999.00964.x.

    Article  PubMed  Google Scholar 

  15. Victorzon M, Tolonen P. Laparoscopic silicone adjustable gastric band: initial experience in Finland. Obes Surg. 2000;10(4):369–71. https://doi.org/10.1381/096089200321629157.

    Article  CAS  PubMed  Google Scholar 

  16. Paganelli M, Giacomelli M, Librenti M, Pontiroli A, Ferla G. Thirty months experience with laparoscopic adjustable gastric banding. Obes Surg. 2000;10(3):269–71.

    Article  CAS  Google Scholar 

  17. Chevallier J, Zinzindohoué F, Elian N, Cherrak A, Blanche J, Berta J, Cugnenc P. Adjustable gastric banding in a public university hospital: prospective analysis of 400 patients. Obes Surg. 2002;12(1):93–9. https://doi.org/10.1381/096089202321144658.

    Article  CAS  PubMed  Google Scholar 

  18. Rubenstein R. Laparoscopic adjustable gastric banding at a U.S. center with up to 3-year follow-up. Obes Surg. 2002;12(3):380–4.

    Article  Google Scholar 

  19. US Food and Drug Administration: The LAP-BAND adjustable gastric banding system: summary of safety and effectiveness data. PMA: P000008. https://www.accessdata.fda.gov/cdrh_docs/pdf/P000008b.pdf.

  20. Ren C, 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.

    Article  Google Scholar 

  21. Opozda M, Wittert G, Chur-Hansen A. Patients’ reasons for and against undergoing Roux-en-Y gastric bypass, adjustable gastric banding, and vertical sleeve gastrectomy. Surg Obes Relat Dis. 2017;13(11):1887–96. https://doi.org/10.1016/j.soard.2017.07.013.

    Article  PubMed  Google Scholar 

  22. Buchwald H, Oien D. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36. https://doi.org/10.1007/s11695-012-0864-0.

    Article  PubMed  Google Scholar 

  23. Angrisani V. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 5-year results of a prospective randomized trial. Surg Obes Relat Dis. 2007;3(2):127–32.

    Article  Google Scholar 

  24. Tice J, Karliner L, Walsh J, Petersen A, Feldman M. Gastric banding or bypass? A systematic review comparing the two most popular bariatric procedures. Am J Med. 2008;121(10):885–93. https://doi.org/10.1016/j.amjmed.2008.05.036.

    Article  PubMed  Google Scholar 

  25. Sharples A, Charalampakis V, Daskalakis M, Tahrani A, Singhal R. Systematic review and meta-analysis of outcomes after revisional bariatric surgery following a failed adjustable gastric band. Obes Surg. 2017;27(10):2522–36. https://doi.org/10.1007/s11695-017-2677-7.

    Article  PubMed  Google Scholar 

  26. Suter M. Laparoscopic band repositioning for pouch dilatation/slippage after gastric banding: disappointing results. Obes Surg. 2001;11(4):507–12. https://doi.org/10.1381/096089201321209431.

    Article  CAS  PubMed  Google Scholar 

  27. Kohn G, Hansen C, Gilhome R, McHenry R, Spilias D, Hensman C. Laparoscopic management of gastric band erosions: a 10-year series of 49 cases. Surg Endosc. 2012;26(2):541–5. https://doi.org/10.1007/s00464-011-1916-6.

    Article  PubMed  Google Scholar 

  28. ASMBS: Estimate of bariatric surgery numbers, 2011–2017. https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers. Accessed Oct 2018.

  29. Suter M, Calmes J, Paroz A, Giusti V. A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg. 2006;16(7):829–35. https://doi.org/10.1381/096089206777822359.

    Article  CAS  PubMed  Google Scholar 

  30. Chevallier J, Zinzindohoué F, Douard R, Blanche J, Berta J, Altman J, Cugnenc P. Complications after laparoscopic adjustable gastric banding for morbid obesity: experience with 1,000 patients over 7 years. Obes Surg. 2004;14(3):407–14. https://doi.org/10.1381/096089204322917954.

    Article  PubMed  Google Scholar 

  31. Shen X, Zhang X, Bi J, Yin K. Long-term complications requiring reoperations after laparoscopic adjustable gastric banding: a systematic review. Surg Obes Relat Dis. 2015;11(4):956–64. https://doi.org/10.1016/j.soard.2014.11.011.

    Article  PubMed  Google Scholar 

  32. Koh CY, et al. Laparoscopic adjustable gastric band explantation and implantation at academic centers. J Am Coll Surg. 2017;225(4):532–3. https://doi.org/10.1016/j.jamcollsurg.2017.06.015.

    Article  PubMed  Google Scholar 

  33. Aarts E, Dogan K, Koehestanie P, Aufenacker T, Janssen I, Berends F. Long-term results after laparoscopic adjustable gastric banding: a mean fourteen year follow-up study. Surg Obes Relat Dis. 2014;10(4):633–40. https://doi.org/10.1016/j.soard.2014.03.019.

    Article  CAS  PubMed  Google Scholar 

  34. Arapis K, Tammaro P, Parenti L, Pelletier A, Chosidow D, Kousouri M, Marmuse J. Long-term results after laparoscopic adjustable gastric banding for morbid obesity: 18-year follow-up in a single university unit. Obes Surg. 2017;27(3):630–40. https://doi.org/10.1007/s11695-016-2309-7.

    Article  CAS  PubMed  Google Scholar 

  35. O’Brien PE, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006;16(8):1032–40. https://doi.org/10.1381/096089206778026316.

    Article  PubMed  Google Scholar 

  36. Himpens J, Cadière G, Bazi M, Vouche M, Cadière B, Dapri G. Long-term outcomes of laparoscopic adjustable gastric banding. Arch Surg. 2011;146(7):802–7. https://doi.org/10.1001/archsurg.2011.45.

    Article  PubMed  Google Scholar 

  37. Victorzon M, Tolonen P. Mean fourteen-year, 100% follow-up of laparoscopic adjustable gastric banding for morbid obesity. Surg Obes Relat Dis. 2013;9(5):753–7. https://doi.org/10.1016/j.soard.2013.05.010.

    Article  PubMed  Google Scholar 

  38. O’Brien PE, et al. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg. 2012;257(1):87–94. https://doi.org/10.1097/SLA.0b013e31827b6c02.

    Article  Google Scholar 

  39. Spann MD, et al. Endoscopic management of erosion after banded bariatric procedures. Surg Obes Relat Dis. 2017;13(11):1875–9. https://doi.org/10.1016/j.soard.2017.07.025.

    Article  PubMed  Google Scholar 

  40. Quadri P, et al. Management of laparoscopic adjustable gastric band erosion. Surg Endosc. 2017;31(4):1505–12. https://doi.org/10.1007/s00464-016-5183-4.

    Article  PubMed  Google Scholar 

  41. Brown WA, et al. Erosions after laparoscopic adjustable gastric banding: diagnosis and management. Ann Surg. 2013;257(6):1047–52. https://doi.org/10.1097/SLA.0b013e31826bc21b.

    Article  PubMed  Google Scholar 

  42. Kurian M, Sultan S, Garg K, Youn H, Fielding G, Ren-Fielding C. Evaluating gastric erosion in band management: an algorithm for stratification of risk. Surg Obes Relat Dis. 2010;6(4):386–9. https://doi.org/10.1016/j.soard.2009.11.020.

    Article  PubMed  Google Scholar 

  43. Lattuada E, Zappa M, Mozzi E, Gazzano G, Francese M, Antonini I, Roviaro G. Histologic study of tissue reaction to the gastric band: does it contribute to the problem of band erosion? Obes Surg. 2006;16(9):1155–9. https://doi.org/10.1381/096089206778392338.

    Article  PubMed  Google Scholar 

  44. Angus L, Rizvon K, Zhou D, Seitelman E, Cardoza S. Intra-gastric band erosion from an un-inflated Lap-Band: a case report. Obes Surg. 2008;18(12):1636–9. https://doi.org/10.1007/s11695-008-9618-4.

    Article  PubMed  Google Scholar 

  45. Salar O, Waraich N, Singh R, Awan A. Gastric band erosion, infection and migration causing jejunal obstruction. BMJ Case Rep. 2013;2013 https://doi.org/10.1136/bcr-2012-007737.

    Google Scholar 

  46. Brown W, Burton P, Anderson M, Korin A, Dixon J, Hebbard G, O’Brien P. Symmetrical pouch dilatation after laparoscopic adjustable gastric banding: incidence and management. Obes Surg. 2008;18(9):1104–8. https://doi.org/10.1007/s11695-008-9485-z.

    Article  PubMed  Google Scholar 

  47. Moser F, Gorodner M, Galvani C, Baptista M, Chretien C, Horgan S. Pouch enlargement and band slippage: two different entities. Surg Endosc. 2006;20(7):1021–9. https://doi.org/10.1007/s00464-005-0269-4.

    Article  CAS  PubMed  Google Scholar 

  48. O’Brien P, Dixon J, Laurie C, Anderson M. A prospective randomized trial of placement of the laparoscopic adjustable gastric band: comparison of the perigastric and pars flaccida pathways. Obes Surg. 2005;15(6):820–6. https://doi.org/10.1381/0960892054222858.

    Article  PubMed  Google Scholar 

  49. Swenson D, Pietryga J, Grand D, Chang K, Murphy B, Egglin T. Gastric band slippage: a case-controlled study comparing new and old radiographic signs of this important surgical complication. Am J Roentgenol AJR. 2014;203(1):10–6. https://doi.org/10.2214/AJR.13.11650.

    Article  Google Scholar 

  50. Pieroni S, Sommer E, Hito R, Burch M, Tkacz J. The “O” sign, a simple and helpful tool in the diagnosis of laparoscopic adjustable gastric band slippage. Am J Roentgenol AJR. 2010;195(1):137–41. https://doi.org/10.2214/AJR.09.3933.

    Article  Google Scholar 

  51. Burton P, Brown W, Laurie C, Hebbard G, O’Brien P. Predicting outcomes of intermediate term complications and revisional surgery following laparoscopic adjustable gastric banding: utility of the CORE classification and Melbourne motility criteria. Obes Surg. 2010;20(11):1516–23. https://doi.org/10.1007/s11695-010-0258-0.

    Article  PubMed  Google Scholar 

  52. Ooi G, Burton P, Laurie C, Hebbard G, O’Brien P, Brown W. Nonsurgical management of luminal dilatation after laparoscopic adjustable gastric banding. Obes Surg. 2014;24(4):617–24. https://doi.org/10.1007/s11695-013-1126-5.

    Article  PubMed  Google Scholar 

  53. Tolonen P, Victorzon M, Niemi R, Mäkelä J. Does gastric banding for morbid obesity reduce or increase gastroesophageal reflux? Obes Surg. 2006;16(11):1469–74. https://doi.org/10.1381/096089206778870120.

    Article  PubMed  Google Scholar 

  54. Chen R, Burton P, Ooi G, Laurie C, Smith A, Crosthwaite G, Brown W. The physiology and pathophysiology of gastroesophageal reflux in patients with laparoscopic adjustable gastric band. Obes Surg. 2017;27(9):2434–43. https://doi.org/10.1007/s11695-017-2662-1.

    Article  PubMed  Google Scholar 

  55. Tchokouani L, et al. The long-term effects of the adjustable gastric band on esophageal motility in patients who present for band removal. Obes Surg. 2018;28(2):333–7. https://doi.org/10.1007/s11695-017-2842-z.

    Article  PubMed  Google Scholar 

  56. Ayloo S, Fernandes E, Masrur M, Giulianotti P. Adjustable gastric banding: a comparison of models. Surg Obes Relat Dis. 2014;10(6):1097–103. https://doi.org/10.1016/j.soard.2013.09.003.

    Article  PubMed  Google Scholar 

  57. Pujol Rafols J, Al Abbas A, Devriendt S, Guerra A, Herrera M, Himpens J, Van Wagensveld B. Roux-en-Y gastric bypass, sleeve gastrectomy, or one anastomosis gastric bypass as rescue therapy after failed adjustable gastric banding: a multicenter comparative study. Surg Obes Relat Dis. 2018;14(11):1659–66. https://doi.org/10.1016/j.soard.2018.08.005.

    Article  PubMed  Google Scholar 

  58. Yeung L, Durkan B, Barrett A, Kraft C, Vu K, Phillips E, Burch M. Single-stage revision from gastric band to gastric bypass or sleeve gastrectomy: 6- and 12-month outcomes. Surg Endosc. 2016;30(6):2244–50. https://doi.org/10.1007/s00464-015-4498-x.

    Article  PubMed  Google Scholar 

  59. Carandina S, Maldonado P, Tabbara M, Valenti A, Rivkine E, Polliand C, Barrat C. Two-step conversion surgery after failed laparoscopic adjustable gastric banding. Comparison between laparoscopic Roux-en-Y gastric bypass and laparoscopic gastric sleeve. Surg Obes Relat Dis. 2014;10(6):1085–91. https://doi.org/10.1016/j.soard.2014.03.017.

    Article  PubMed  Google Scholar 

  60. Goitein D, Feigin A, Segal-Lieberman G, Goitein O, Papa M, Zippel D. Laparoscopic sleeve gastrectomy as a revisional option after gastric band failure. Surg Endosc. 2011;25(8):2626–30. https://doi.org/10.1007/s00464-011-1615-3.

    Article  PubMed  Google Scholar 

  61. Van Nieuwenhove Y, Ceelen W, Van Renterghem K, Van de Putte D, Henckens T, Pattyn P. Conversion from band to bypass in two steps reduces the risk for anastomotic strictures. Obes Surg. 2011;21(4):501–5. https://doi.org/10.1007/s11695-010-0331-8.

    Article  PubMed  Google Scholar 

  62. Schäfer A, Gehwolf P, Umlauft J, Dziodzio T, Biebl M, Perathoner A, Wykypiel H. Revisional gastric bypass after failed adjustable gastric banding-one-stage or two-stage procedure? Obes Surg. 2018;29(3):943–8. https://doi.org/10.1007/s11695-018-3614-0.

    Article  Google Scholar 

  63. Dang J, Switzer N, Wu J, Gill R, Shi X, Thereaux J, Karmali S. 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.

    Article  PubMed  Google Scholar 

  64. 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.

    Article  PubMed  Google Scholar 

  65. Janik M, Rogula T, Mustafa R, Alhaj Saleh A, Khaitan L. Safety of revision sleeve gastrectomy compared to Roux-Y gastric bypass after failed gastric banding: analysis of the MBSAQIP. Ann Surg. 2019;269(2):299–303. https://doi.org/10.1097/SLA.0000000000002559.

    Article  PubMed  Google Scholar 

  66. Lattuada E, Zappa M, Mozzi E, Fichera G, Granelli P, De Ruberto F, Roviaro G. Band erosion following gastric banding: how to treat it. Obes Surg. 2007;17(3):329–33.

    Article  Google Scholar 

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Authors and Affiliations

  1. Monmouth Medical Center, Department of Surgery, Long Branch, NJ, USA

    Jeffrey D. Sohn & James C. Botta

  2. Monmouth Medical Center, Long Branch, NJ, USA

    Gurdeep S. Matharoo

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  1. Monmouth Medical Center, Long Branch, NJ, USA

    Frank J. Borao

  2. Monmouth Medical Center, Long Branch, NJ, USA

    Steven J. Binenbaum

  3. Monmouth Medical Center, Long Branch, NJ, USA

    Gurdeep S. Matharoo

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Sohn, J.D., Botta, J.C., Matharoo, G.S. (2020). Revision of the Laparoscopic Gastric Band. In: Borao, F., Binenbaum, S., Matharoo, G. (eds) Revisional Foregut Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-28273-8_1

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