Early results of conversion of laparoscopic adjustable gastric band to Roux-en-Y gastric bypass

Band revision versus Roux-en-Y gastric bypass conversion as salvage operation after laparoscopic adjustable gastric banding

“…In our study, the %EBWL was 26.4% at 24 months, the point before which most patients had undergone conversion. This was similar to the 23% EBWL reported by Moore et al [14] in their conversion group. Our results have demonstrated an increase in overall %EBWL from 26% at 24 months, to 48% at 36 and 48 months for patients who underwent conversion (Table 1).…”

“…Although reoperation rates of Ͼ50% have been reported in band patients followed up for 10 years [11], the typical reoperation rates in large series have been 20 -30% [12,13], consistent with our data. We had an overall reoperation rate of 20.6% (15.3% excluding band removal and port-related complications), similar to the 15% observed in other studies [14,15].…”

“…For those undergoing conversion, the average interval to surgery was 27.6 months after primary LAGB replacement, similar to the 28.2 months reported by Spivak et al [9] and 29 months reported by Moore et al [14] but shorter than that reported by Mognol et al [8], at 42 months. The main indication for conversion to RYGB was inadequate weight loss (84.2% of cases).…”

Surgical Management of Adjustable Gastric Band Failures and Literature Review: Algorithm for Removal and Conversion

“…Resting pressure high, relaxes properly 92% peristaltic, 8% simultaneous, 0% failed a Full HRM report not available in patient's medical record, but normal results were documented by her surgeon the surgical literature is the 1-stage vs. 2-staged operative approach to conversions after failed LAGB. While roughly 60% of our AGB-to-SG and 65% of our AGB-to-RYGB conversions were done in 2 stages ( Table 2), 60% of patients (n = 1223) in a recent systematic review by Sharples et al (10) and ≥ 70% of patients across multiple US studies have undergone 1-stage conversions as shown in Table 5 [12][13][14][15][16][17][18][19][20][21]. There is no level I evidence supporting the superiority of a staged approach for revisional bariatric surgery following AGB removal.…”

Risk Factors for Postoperative Morbidity After Totally Robotic Gastric Bypass in 302 Consecutive Patients

“…Higher incidence of postoperative morbidity after revisional laparoscopic or open RYGB is considered to be secondary to intraoperative difficulties to recognize actual anatomy during dissection, complex adhesiolysis during pouch construction, and gastrojejunostomy anastomosis performed on friable and inflamed tissues due to prior dissection [22,[24][25][26][27][28][29][30][31]. Consequently, postoperative morbidity rate has been reported from 11 to 38 % when RYGBP is performed after vertical banded gastroplasty (VBG) and from 6 to 46 % after adjustable gastric banding (AGB) [32][33][34][35][36][37][38][39][40][41]. In this setting, the robotic approach has been proposed to perform RYGBP after failed previous bariatric surgical procedures because it is considered to be associated with improved postoperative morbidity in comparison with conventional laparoscopic or open approaches [2,22,29,31,40,42].…”