Laparoscopic Adjustable Silicone Gastric Banding (Lap-Band®): How To Avoid Comlications

“…Some procedures place obstacles against food ingestion, through the use of narrowing anastomoses or sometimes the use of prostheses. 2 These imply dysphagia, vomiting, stasis esophagitis, etc. Many of the current procedures involve digestive tract exclusions that cause atrophy of the mucosa, with bacterial proliferation that leads to intense fl atulence and sometimes bacterial translocation to the portal system.…”

Section: Introductionmentioning

confidence: 99%

Preliminary results from digestive adaptation: a new surgical proposal for treating obesity, based on physiology and evolution

et al. 2006

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CONTEXT AND OBJECTIVE: Most bariatric surgical techniques include essentially non-physiological features like narrowing anastomoses or bands, or digestive segment exclusion, especially the duodenum. This potentially causes symptoms or complications. The aim here was to report on the preliminary results from a new surgical technique for treating morbid obesity that takes a physiological and evolutionary approach. DESIGN AND SETTING: Case series description, in Hospital Israelita Albert Einstein and Hospital da Polícia Militar, São Paulo, and Hospital Vicentino, Ponta Grossa, Paraná. METHODS: The technique included vertical (sleeve) gastrectomy, omentectomy and enterectomy that retained three meters of small bowel (initial jejunum and most of the ileum), i.e. the lower limit for normal adults. The operations on 100 patients are described. RESULTS: The mean follow-up was nine months (range: one to 29 months). The mean reductions in body mass index were 4.3, 6.1, 8.1, 10.1 and 10.7 kg/m², respectively at 1, 2, 4, 6 and 12 months. All patients reported early satiety. There was major improvement in comorbidities, especially diabetes. Operative complications occurred in 7% of patients, all of them resolved without sequelae. There was no mortality. CONCLUSIONS: This procedure creates a proportionally reduced gastrointestinal tract, leaving its basic functions unharmed and producing adaptation of the gastric chamber size to hypercaloric diet. It removes the sources of ghrelin, plasminogen activator inhibitor-1 (PAI-1) and resistin production and leads more nutrients to the distal bowel, with desirable metabolic consequences. Patients do not need nutritional support or drug medication. The procedure is straightforward and safe.

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“…8 The incidence of revision has been reported between 3.5% and 60% after LAGB. 9,10 In our study, all patients who underwent revision had previous restrictive procedures.…”

Section: Discussionmentioning

confidence: 96%

Revision Surgery in Bariatric Surgery: Initial Experience

Alptekın¹,

Yılmaz²,

Kafali³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T OOb bj je ec ct ti iv ve e: : Revision surgery in bariatric surgery is becoming an important issue. It has been associated with higher complication rates, and there is no consensus on the standardized surgical approach to revision surgery. The aim of this study was to review the revision procedures performed in our institute. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A retrospective review of a prospectively maintained database was performed. One hundred thirty three operations were performed for morbid obesity. Primary procedures were laparoscopic adjustable gastric banding (LAGB) in 61 patients, vertical band gastroplasty (VBG) in 24 patients, Roux-en-Y gastric bypass in 21 patients, sleeve gastrectomy in 10 patients and biliopancreatic diversion with duodenal switch in six patients. Eleven patients were reoperated due to mechanical complications or inadequate weight loss. Data including age, gender, preoperative weight, body mass index (BMI) and postoperative complications were reviewed for all patients undergoing a revision procedure. R Re es su ul lt ts s: In patients with previous VBG, failure of weight loss (3/4) and outlet stenosis (1/4) were the indications. In patients with previous LAGB, mechanical side effects were the indications of surgery. The gastrocolic fistula was the indication of surgery in patient who had been revised from VBG to sleeve gastrectomy. At the mean follow-up of 13 months, the mean BMI and percentage of excess BMI were 32.3 kg/m 2 and 37.4%, respectively. There was one stapler-line leakage. C Co on nc cl lu us si io on n: : Our study suggests that revision bariatric surgery can be performed with satisfactory short-term weight loss. The knowledge of the potential complications associated with revision surgery and their management is crucial for patients' safety. K Ke ey y W Wo or rd ds s: : Obesity; bariatric surgery; reoperation; body mass index Ö ÖZ ZE ET T A Am ma aç ç: : Bariatrik cerrahide revizyonel cerrahi önemli bir konu haline gelmektedir. Yüksek komplikasyon oranları ile ilişkili bulunmuştur ve revizyonel cerrahide standart cerrahi yaklaşımla ilgili fikir birliği yoktur. Bu çalışmanın amacı bizim merkezimizde yapılan revizyonel cerrahilerin göz-den geçirilmesidir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : İleri dönük olarak sürdürülen veri tabanı geriye dönük olarak gözden geçirildi. Morbid obezite nedeniyle 133 ameliyat yapıldı. Birincil ameliyat 61 hastada laparoskopik ayarlanabilir gastrik bantlama (LAGB), 24 hastada vertikal bantlı gastroplasti (VBG), 21 hastada Roux-en-Y gastrik baypas, 10 hastada sleeve gastrektomi ve altı hastada duodenal switch ile biliopankreatik diversiyondu. Onbir hasta mekanik komplikasyonlar veya yetersiz kilo kaybı nedeniyle tekrar ameliyat edildi. Yaş, cinsiyet, ameliyat öncesi ağırlık, beden kitle indeksi (BKİ) (bariatrik ve revizyonel cerrahiden önce) ve postoperatif komplikasyonları içeren veriler revizyon işlemi yapılan tüm hastalarda gözden geçirildi. B Bu ul lg gu ul la ar r: : D...

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Laparoscopic Adjustable Silicone Gastric Banding (Lap-Band®): How To Avoid Comlications

Abstract: Attention to technical details is of paramount importance for a safe, standardized and effective operation.

Cited by 152 publications

References 3 publications

High Failure Rate After Laparoscopic Adjustable Silicone Gastric Banding for Treatment of Morbid Obesity

High Failure Rate After Laparoscopic Adjustable Silicone Gastric Banding for Treatment of Morbid Obesity

Preliminary results from digestive adaptation: a new surgical proposal for treating obesity, based on physiology and evolution

Revision Surgery in Bariatric Surgery: Initial Experience

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