Indications and Results of Reversal of Vertical Banded Gastroplasty (VBG)

Thoreson, Rebecca; Cullen, Joseph J.

doi:10.1007/s11605-008-0658-9

Cited by 15 publications

(7 citation statements)

References 11 publications

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“…Revisional surgery is associated with a high rate of symptomatic resolution. Thoreson et al found that symptom resolution rates were high in 27 patients to undergo reversal of VBG via gastrogastrostomy (89% symptom improvement) [10]. Contrary to our findings, after 32 months follow-up significant weight gain was not observed in these patients.…”

Section: Discussioncontrasting

confidence: 99%

Revisional Surgery for Failed Vertical-Banded Gastroplasty

2011

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Vertical-banded gastroplasty (VBG) was once a common bariatric procedure. It has fallen out of favor due to the emergence of the adjustable gastric band and late complications including band erosion and stenosis. Options for revision include conversion to a Roux-en-Y gastric bypass (RYGB) or VBG reversal via gastrogastrostomy. Patients undergoing revision of a previous VBG were identified. VBG reversal was performed laparoscopically. Conversion to RYGB was performed by both laparotomy and laparoscopy. Perioperative outcomes and long-term weight loss were evaluated. A total of 34 patients with a previous open VBG underwent revision over a nearly 8-year period (January 2003 to September 2010). Conversion to RYGB was performed in 25 (four laparoscopically) and VBG reversal in nine patients. Mean age for all patients was 56.3 years (range 36-70), and VBG had been performed 23 years previously (range 16-30). Patients to undergo VBG reversal were more likely to be male and less likely to be morbidly obese at the time of revision. Operative time and length of stay were shorter for laparoscopic procedures. Complication rates did not differ based on technique or procedure. Patients with a previous VBG may present with complications and obesity decades after the primary procedure. Revisional surgery can be accomplished laparoscopically. Following VBG reversal, most patients gain weight and many become morbidly obese again. Conversion to RYGB is associated with weight loss and resolution of morbid obesity in most patients. When feasible, laparoscopic conversion to RYGB may offer the best outcomes.

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Section: Discussioncontrasting

confidence: 99%

Revisional Surgery for Failed Vertical-Banded Gastroplasty

2011

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“…Furthermore, GERD is the most frequent cause for reversal surgery: In a recent analysis on patients who underwent a reversal of a VBG [24], the rate of reflux as presenting symptom was 67%. The conversion into Roux-en-Y gastric bypass is an effective technique for VBG patients who suffered from GERD: In a study on 25 patients with severe GERD after VBG who subsequently underwent a conversion to a gastric bypass, 96% of the patients were symptom free after the surgical conversion at a mean follow-up of 37 months [25].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Adjustable Silicone Gastric Banding vs Laparoscopic Vertical Banded Gastroplasty in Morbidly Obese Patients: Long-Term Results of a Prospective Randomized Controlled Clinical Trial

et al. 2009

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“…Even accounting for cases where technical difficulty was encountered, the mean operating time in our series was 50 minutes. Laparoscopic reversal may be sufficiently challenging that open revision remains popular [7]. creating disorientation as seen in one of our cases in the series.…”

Section: Discussionmentioning

confidence: 86%