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Laparoscopic vertical banded gastroplasty

A multicenter prospective study of 200 procedures

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Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

The commonest surgical procedure for management of morbid obesity in Europe is laparoscopic adjustable gastric banding (LAGB), even though laparoscopic vertical banded gastroplasty (LVBG) is still considered to be a gold standard restrictive option in bariatric surgery. A multicenter prospective study was designed to to assess the efficacy of LVBG in terms of weight loss and complication rates for obese patients who have indications for a restrictive procedure.

Patients and methods

Two-hundred morbidly obese patients (84.5% female) with a mean age of 41 years and mean body mass index (BMI) of 43.2 kg/m2 underwent LVBG as described by MacLean. Five trocars were placed in standard positions as per laparoscopic upper gastrointestinal surgery. A vertical gastric pouch (30 ml) was created with circular (21 or 25mm) and endolinear stapling techniques, enabling definitive separation of the two parts of the stomach. The gastric outlet was calibrated with either a polypropylene mesh (5.5 cm in length and 1cm in width) or a nonadjustable silicone band. The median follow-up period was 30 months (range, 1–72 months).

Results

One case had to be converted to open surgery (gastric perforation) and there was one death secondary to peritonitis of unknown etiology. The morbidity rate was 24%, comprising the following complications: gastric outlet stenosis (8%); staple line leak (2.5%); food trapping (1.5%); peritonitis (1%); thrombophlebitis (1.5%); pulmonary embolism (0.5%); and gastroesophageal reflux (9%). The excess weight loss achieved was 56.7% (1 year), 68.3% (2 years), and 65.1% (3 years).

Conclusions

Laparoscopic vertical banded gastroplasty is an effective procedure for the surgical management of morbid obesity, especially for patients who present hyperphagia but are unable to manage the constraints of adjustable gastric banding. Laparoscopic vertical banded gastroplasty is safe, as demonstrated by an acceptable complication rate, of which gastric outlet stenosis, staple line leakage, and gastroesophageal reflux predominate.

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References

  1. Bloomberg RD, Urbach DR (2002) Laparoscopic Roux-en-Y gastric bypass for severe gastroesophageal reflux after vertical banded gastroplasty. Obes Surg 12:408–411

    Article  PubMed  Google Scholar 

  2. Consten EC, Gagner M, Pomp A, Inabnet WB (2004) Decreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane. Obes Surg 14:1360–1366

    Article  PubMed  Google Scholar 

  3. Davila-Cervantes A, Borunda D, Dominguez-Cherit G, Gamino R, Vargas-Vorackova F, Gonzalez-Barranco J, Herrera MF (2002) Open versus laparoscopic vertical banded gastroplasty: a randomized controlled double blind trial. Obes Surg 12:812–818

    Article  PubMed  Google Scholar 

  4. Fobi M, Lee H, Holness R, Cabinda D (1998) Gastric bypass operation for obesity. World J Surg 22:964–968

    Article  Google Scholar 

  5. Gavert N, Szold A, Abu-Abeid S (2003) Laparoscopic revisional surgery for life-threatening stenosis following vertical banded gastroplasty, together with placement of an adjustable gastric band. Obes Surg 13:399–403

    Article  PubMed  Google Scholar 

  6. Gentileschi P, Kini S, Catarci M, Gagner M (2002) Evidence-based medicine: open and laparoscopic bariatric surgery. Surg Endosc 16:736–744

    Article  PubMed  CAS  Google Scholar 

  7. Karlsson J, Sjôstrôm L, Sullivan M (1998) Swedish Obese Subjects (SOS)–An intervention study of obesity. Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity. Int J Obes 22:113–126

    Article  CAS  Google Scholar 

  8. Lee WJ, Huang MT, Yu PJ, Wang W, Chen TC (2004) Laparoscopic vertical banded gastroplasty and laparoscopic gastric bypass: a comparison. Obes Surg 14:626–634

    Article  PubMed  Google Scholar 

  9. Lointier PH, Verdier PH, Verdier A (2002) The LM Proring Band and left approach in laparoscopic vertical banded gastroplasty: preliminary results in 44 cases. Obes Surg 12:672–678

    Article  PubMed  CAS  Google Scholar 

  10. Mason EE (1982) Vertical banded gastroplasty for obesity. Ann Surg 117:701–706

    CAS  Google Scholar 

  11. MacLean LD, Rhode BM, Sampalis J, Forse RA (1993) Results of the surgical treatment of obesity. Am J Surg 165:155–160; discussion 160–162

    Article  PubMed  CAS  Google Scholar 

  12. MacLean LD, Rhode BM, Forse RA (1990) Late results of vertical banded gastroplasty for morbid and super obesity. Surgery 107:20–27

    PubMed  CAS  Google Scholar 

  13. MacLean LD, Rhode BM, Forse RA (1993) A gastroplasty that avoids stapling in continuity. Surgery 113:380–388

    PubMed  CAS  Google Scholar 

  14. Magnusson M, Freedman J, Jonas E, Stockeld D, Granstrom L, Naslund E (2002) Five-year results of laparoscopic vertical banded gastroplasty in the treatment of massive obesity. Obes Surg 12:826–830

    Article  PubMed  Google Scholar 

  15. Morino M, Toppino M, Bonnet G, del Genio G (2003) Laparoscopic adjustable silicone gastric banding versus vertical banded gastroplasty in morbidly obese patients: a prospective randomized controlled clinical trial. Ann Surg 238:835–841; discussion 841–842

    Article  PubMed  Google Scholar 

  16. Morino M, Toppino M, Bonnet G, Rosa R, Garrone C (2002) Laparoscopic vertical banded gastroplasty for morbid obesity. Assessment of efficacy. Surg Endosc 16:1566–1572

    Article  PubMed  CAS  Google Scholar 

  17. Naslund E, Freedman J, Lagergren J, Stockeld D, Granstrom L (1999) Three-year results of laparoscopic vertical banded gastroplasty. Obes Surg 9:369–373

    Article  PubMed  CAS  Google Scholar 

  18. National Institutes of Health (1991) Consensus Development Conference Draft Statement on Gastrointestinal Surgery for Severe Obesity 25–27 March 1991. Obesity Surg 1:257–265

    Article  Google Scholar 

  19. Nocca D, Frering V, Gallix B, des Hons CD, Noel P, Foulonge MA, Millat B, Fabre JM (2005) Migration of adjustable gastric banding from a cohort study of 4236 patients. Surg Endosc 19:947–950

    Article  PubMed  CAS  Google Scholar 

  20. Nocca D, Gagner M, Aggarwal R, Deneve E, Millat B, Pourquier D, Fabre JM (2006) Is collagen a good banding material for outlet control of vertical gastroplasty? Preliminary study in pigs. Obes Surg 16:39–44

    Article  PubMed  Google Scholar 

  21. Olbers T, Fagevik-Olsen M, Maleckas A, Lonroth H (2005). Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic vertical banded gastroplasty for obesity. Br J Surg 92:557–562

    Article  PubMed  CAS  Google Scholar 

  22. Silecchia G, Restuccia A, Elmore U, Polito D, Perrotta N, Genco A, Bacci V, Basso N (2001) Laparoscopic adjustable silicone gastric banding: prospective evaluation of intragastric migration of the lap-band. Surg Laparosc Endosc Percutan Tech 11:229–234

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Digestive Surgery Pr Fabre, Hopital Saint Eloi, University Hospital of Montpellier, Avenue Bertin SANS, 34000, Montpellier, France

    D. Nocca, P. Blanc, E. Deneve, G. Tincani & J. M. Fabre

  2. Department of Biosurgery & Surgical Technology, Imperial College London, London, United Kingdom

    R. Aggarwal

  3. Clinique Saint Louis, PL Joseph Boudouresques, 34190, Ganges, France

    C. Seguin des De Hons

  4. Department of Radiology Pr Bruel, Hopital Saint Eloi, University Hospital of Montpellier, Avenue Bertin SANS, 34000, Montpellier, France

    B. Gallix & M. A. Pierredon

  5. Department of Digestive Surgery Pr Millat, Hopital Saint Eloi, University Hospital of Montpellier, Avenue Bertin SANS, 34000, Montpellier, France

    G. L. Di Mauro, B. Millat & J. G. Rodier

Authors
  1. D. Nocca
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  2. R. Aggarwal
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  3. P. Blanc
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  4. B. Gallix
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  5. G. L. Di Mauro
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  6. B. Millat
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  7. C. Seguin des De Hons
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  8. E. Deneve
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  9. J. G. Rodier
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  10. G. Tincani
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  11. M. A. Pierredon
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  12. J. M. Fabre
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Corresponding author

Correspondence to D. Nocca.

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Nocca, D., Aggarwal, R., Blanc, P. et al. Laparoscopic vertical banded gastroplasty. Surg Endosc 21, 870–874 (2007). https://doi.org/10.1007/s00464-006-9048-0

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  • DOI: https://doi.org/10.1007/s00464-006-9048-0

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