Roux-en-Y Gastric Bypass After Previous Unsuccessful Gastric Restrictive Surgery

Westling, Agneta; Öhrvall, Màrgàretà; Gustavsson, Sven

doi:10.1016/s1091-255x(01)00035-x

Cited by 88 publications

(32 citation statements)

References 25 publications

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“…Furthermore, complication rates are similar to rebanding rates [11,14,17,[20][21][22]24]. When revisional surgery is performed by experienced hands, creation of an LRYGB after failed AGB can have similar complication rates as primary LRYGB surgery [8,14,17,19,21,24,25]. The recent 21:1931-1935 1933 series by Spivak, in which 33 patients underwent a conversion of band to gastric bypass, confirmed the results of previous series without mortality, with two severe complications (one splenectomy and one internal hernia), which can be considered a technical error [29].…”

Section: Discussionmentioning

confidence: 60%

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Gastric banding: Conversion to sleeve, bypass, or DS

Gautier

Gumbs

2007

Surg Endosc

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A review of conversions of gastric banding for obesity to Roux-en-Y gastric bypass, gastric sleeve, or duodenal switch attempts to determine which revisional procedure best enhances weight loss. Indications for these conversions are multiple and include hardware problems, motility problems, and miscellaneous like inadequate weight loss. Analysis of band conversions to band of 193 patients, and bands to gastric bypass in 214 patients reveals better weight loss with the latter strategy. Smaller cohorts of patients who underwent a biliopancreatic diversion or simply a sleeve gastrectomy are too small to conclude on their efficacy. Prospective randomized trials are needed to determine which revisional procedure is best in the setting of inadequate weight loss of excessive weight regain after gastric adjustable banding for severe obesity.

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Section: Discussionmentioning

confidence: 60%

“…Nonetheless, in the setting of inadequate weight loss after band placement, RYGB appears to be a superior procedure [8,14,17,19,21,24,25]. Of four studies analyzing the results after rebanding only one reported postoperative BMI, and it was unchanged after 12 months [11,14,20,22].…”

Section: Discussionmentioning

confidence: 99%

Gastric banding: Conversion to sleeve, bypass, or DS

Gautier

Gumbs

2007

Surg Endosc

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“…The complications associated with revision include postoperative gastric remnant dilation requiring a gastrostomy tube and diaphragmatic injury with the need to restaple the pouch secondary to stapling in a foreign body [26,27].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic conversion of vertical banded gastroplasty to a Roux-en-Y gastric bypass

2007

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The vertical banded gastroplasty was the mainstay of bariatric surgery for over a decade. Though this procedure is now rarely performed many of these patients will present with failure or maladaptive eating and its sequelae. Some of these patients who demonstrate the motivation for lifestyle modification as well as many of these with complications will be candidates for revisional surgery. This article reviews the technical challenges in performing these revisions using minimally invasive techniques. In addition it reviews outcomes of laparoscopic conversion and tips for patient selection and success.

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“…In past decades, several procedures have been used that have since fallen out of favor [212]. A number of pure restrictive procedures that involved gastric partitioning with staples have been limited by stomal dilation or recanalization of nondivided staple lines [213,214]. Even procedures acceptable by current standards, such as VBG [215], RGB [216], and AGB, are at risk for Lap laparoscopic, AGB adjustable gastric banding, RGB Roux-en-Y gastric bypass, BPD biliopancreatic diversion Guidelines for laparoscopic AGB • The pars flaccida approach for laparoscopic AGB placement should be used instead of the perigastric approach to decrease the incidence of gastric prolapse (level 2) • Laparoscopic AGB is effective in all BMI subgroups, with durable weight loss and control of comorbidities past 5 years (level 1) • Intermediate-term weight loss after laparoscopic AGB may be less than after laparoscopic RGB (level 1) • Frequent outpatient visits are suggested in the early postoperative period.…”

Section: Anatomic Failurementioning

confidence: 99%