Management of failed adjustable gastric banding

Biertho, Laurent; Steffen, Rudolf; Branson, Ruth; Potoczna, Natascha; Ricklin, Thomas; Piec, Grazyna; Horber, Fritz F.

doi:10.1016/j.surg.2004.06.007

Cited by 64 publications

(51 citation statements)

References 22 publications

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“…41 In Sweden, where the same banding systems are utilized, a report of 824 patients with an average preoperative BMI of 43 kg/m 2 demonstrated a 5% reoperation rate secondary to insufficient weight loss. 42 In the US, similar failure rates are seen. A study from Irvine Medical Center where 250 patients were randomly assigned to gastric bypass versus gastric banding reported that 16.7% of patients in the gastric banding arm failed to achieve 20% EWL.…”

Section: Failure Ratesmentioning

confidence: 71%

Past, present, and future: Critical analysis of use of gastric bands in obese patients

Snyder¹,

Worley²,

Aluka³

et al. 2010

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Adjustable gastric banding (AGB) is quickly becoming the most popular bariatric operation performed in the United States and Canada. Patients are particularly fond of the simplicity of the tool, the relatively low morbidity of the surgery, the quick recovery, and overall results. The gastric band has evolved over its 35-year history into a very successful adjustable tool used to restrict food consumption and limit caloric intake. The percent of excessive weight loss after banding can range from 30%-60% and depends on the time out from surgery. Along with weight loss, there is good resolution of the co-morbid conditions that are associated with excess weight and improvements in quality of life demonstrated after banding. Nutrition and follow up are extremely important after banding to ensure good compliance and adequate weight loss. Failure to follow the postoperative diet, exercise regiment, or mechanical failure of the band can lead to failure to lose adequate weight. While there are particular early and late complications associated with this surgery, the safety profile of the AGB is very appealing when compared to other bariatric operations. As we continue to reduce the morbidity of the procedure, the simple adjustable band concept has a lot of potential to remain a primary technique of maintaining long term weight loss. In conclusion, AGB has and continues to play an important role in the treatment of morbid obesity. It offers reasonably good weight loss results with very little morbidity, and the future of the adjustable band is bright.

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Section: Failure Ratesmentioning

confidence: 71%

Past, present, and future: Critical analysis of use of gastric bands in obese patients

Snyder¹,

Worley²,

Aluka³

et al. 2010

DMSO

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“…Postoperative complications and insufficient weight loss followed published criteria and governed the choice of reoperation (10,24). Major reoperations required laparoscopy or laparotomy under general anesthesia, whereas minor reoperations included interventional gastroscopy and port/tube-related abdominal wall procedures not requiring laparotomy or general anesthesia.…”

Section: Definition Of Complications and Reoperationsmentioning

confidence: 99%

“…Major reoperations required laparoscopy or laparotomy under general anesthesia, whereas minor reoperations included interventional gastroscopy and port/tube-related abdominal wall procedures not requiring laparotomy or general anesthesia. Reoperations after gastric bypass were mainly limb resections or the addition of restrictive AGB for inadequate weight loss, whereas primary banding and HYB had pouch revisions for fistula or dilatation (24).…”

Section: Definition Of Complications and Reoperationsmentioning

confidence: 99%

Eating Behavior, Low-Frequency Functional Mutations in the Melanocortin-4 Receptor (MC4R) Gene, and Outcomes of Bariatric Operations: A 6-Year Prospective Study

et al. 2016

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OBJECTIVEData on the effects of eating behavior and genetics on outcomes of gastrointestinal surgery for diabesity have been sparse, often flawed, and controversial. We aimed to assess long-term outcomes of bariatric operations in patients characterized for eating behavior and rare mutations in the melanocortin-4 receptor (MC4R) gene, which is strongly implicated in energy balance. RESEARCH DESIGN AND METHODSBetween 1996 and 2005, 1,264 severely obese Swiss patients underwent current laparoscopic adjustable gastric banding, gastroduodenal bypass, or a hybrid operation. Of these, 872 patients were followed for a minimum of 6 years and were screened for MC4R mutations. Using regression models, we studied relationships between eating behavior and MC4R mutations and postoperative weight loss, complications, and reoperations after 6 years. RESULTSAt baseline, rare functional MC4R mutation carriers exhibited a significantly higher prevalence of binge eating disorder (BED) or loss-of-control eating independent of age, sex, and BMI. Six years after bariatric surgery, the mutation carriers had more major complications than wild-type subjects independent of age, baseline BMI, sex, operation type, and weight loss. Furthermore, high baseline BMI, male sex, BED, and functional MC4R mutations were independent predictors of higher reoperation rates. CONCLUSIONSSequencing of MC4R and eating typology, combined with stratification for sex and baseline BMI, might significantly improve patient allocation to banding or bypass operations for diabesity as well as reduce both complication and reoperation rates.

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“…No data are available concerning the weight loss at the time when reoperation became necessary. However, comparison of these results with others is difficult, as few studies report on results after reoperation after LAGB [11,31,32]. Most studies focus mainly on technical aspects, and the impact of reoperations on weight loss and comorbidities is not reported.…”

Section: Weight Loss After Reoperationmentioning

confidence: 99%

“…This is mainly related to slippage and pouch dilatation [10]. Strategies for reoperations include band replacement, alternative procedures or band removal without further operative therapy [11,12].Against this background, causes and types of reoperations after LAGB as well as effects on weight loss and comorbidities were analyzed. …”

mentioning

confidence: 99%