The fate of laparoscopic adjustable gastric band removal

Falk, Volkmar; Sheppard, Caroline E.; Kanji, Aliyah; Birch, Daniel W.; Karmali, S; Gara, Christopher de

doi:10.1503/cjs.001918

Cited by 18 publications

(8 citation statements)

References 22 publications

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“…One study reported a permanent change in BMI with 47% EWL maintained for up to 15 years after AGB (13). However, due to the experience of AGB and its disadvantages, the rate of surgery has decreased in Europe and worldwide and another type of surgery should eliminate the complication or achieve a significant %TWL in patients with obesity (14)(15)(16). Therefore, due to the high risks of revision surgery, reoperation after failed bariatric surgery must be performed in consultation with the patient (17).…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Short-Term Outcomes of One-Step and Two-Step Sleeve Gastrectomy as Revision Procedures for Failed Adjustable Gastric Banding Compared With Those After Primary Sleeve Gastrectomy

et al. 2021

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Background: The practice of bariatric surgery was studied using the German Bariatric Surgery Registry (GBSR). The focus of the study was to evaluate whether revision surgery One-Step (OS) or Two-Step (TS) sleeve gastrectomy (SG) has a large benefit in terms of perioperative risk in patients after failed Adjustable Gastric Banding (AGB).Methods: The data collection includes patients who underwent One-Step SG (OS-SG) or Two-Step SG (TS-SG) as revision surgery after AGB and primary SG (P-SG) between 2005 and 2019. Outcome criteria were perioperative complications, comorbidities, 30-day mortality, and operating time.Results: The study analyzed data from 27,346 patients after P-SG, 320 after OS-SG, and 168 after TS-SG. Regarding the intraoperative complication, there was a significant difference in favor of P-SG and TS-SG compared to OS-SG (p < 0.001). The incidence of pulmonary complications was significantly higher in the OS-SG (p < 0.001). There was also a significant difference in occurrence of staple line stenosis in favor of TS-SG (p = 0.005) and the occurrence of sepsis (p = 0.008). The mean operating time was statistically longer in the TS-SG group than in the OS-SG group (p < 0.001). The 30-day mortality was not significantly different between the three groups (p = 0.727).Conclusion: In general, our study shows that converting a gastric band to a SG is safe and feasible. However, lower complications were obtained with TS-SG compared to OS-SG. Despite acceptable complication and mortality rates of both procedures, we cannot recommend any surgical method as a standard procedure. Proper patient selection is crucial to avoid possible adverse effects.

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Section: Discussionmentioning

confidence: 99%

Feasibility and Short-Term Outcomes of One-Step and Two-Step Sleeve Gastrectomy as Revision Procedures for Failed Adjustable Gastric Banding Compared With Those After Primary Sleeve Gastrectomy

et al. 2021

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“…However, due to the disadvantages of AGB and complications, the surgery rate has decreased in Europe and worldwide [21]. For this reason, several clinical trials recommend switching to other bariatric procedures to eliminate the complication or achieve a significant %TWL in patients with obesity [22,23,24,25,26]. The primary documented indications for removal of a failed gastric band were dysphagia, weight regain, band slippage, band erosion, band defect, and band sepsis [27,28].…”

Section: Discussionmentioning

confidence: 99%

Safety and short-term outcomes of sleeve gastrectomy and Roux-en-Y gastric bypass following removal of adjustable gastric banding

Thaher¹,

Driouch²,

Hukau³

2021

World J. Adv. Res. Rev.

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Background: The practice of bariatric surgery was studied using the German Bariatric Surgery Registry (GBSR). The focus of the study was to evaluate whether revision sleeve gastrectomy (R-SG) or Roux-en-Y Gastric Bypass (R-RYGB) has a major benefit in terms of perioperative risk in patients after failed Adjustable Gastric Banding (AGB). Methods: The data collection includes patients who underwent SG or RYGB as revision surgery after failed AGB between 2005 and 2019. Outcome criteria were perioperative complications, comorbidities, 30-day mortality, and operative time. Results: The study analyzed data from 1395 patients after revision SG and RYGB. 907 patients after R-RYGB, and 488 after R-SG. Intraoperative and overall postoperative complication rates were not significantly different between the two groups (p=0.321 and 0.621). The specific postoperative complication rate was significantly lower in R-SG than in R-RYGB (p=0.049). The mean operative time differed significantly between the two groups in favor of R-SG (160.3 min vs. 128.3 min; p<0.001). There was no significant difference in 30-day mortality between the two groups (p=0.952). Conclusion: The study shows that R-SG and R-RYGB are safe and feasible as revision procedures and have acceptable complication and mortality rates. However, in our study, we cannot make a recommendation in favor of any of the surgical methods. Proper patient selection is essential to avoid possible adverse effects. Concerning the long-term results, further studies with higher methodological quality are necessary.

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“…In our institution, since 2009, patients with class 1 obesity have been treated with adjustable gastric banding, gastric plication, sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB). As adjustable gastric banding and gastric plication are no longer performed, 16 , 17 we studied outcomes of those who underwent primary laparoscopic sleeve gastrectomy (LSG) or laparoscopic RYGB (LRYGB). The study methodology was in accordance with the Canadian Journal of Surgery protocol for consensus-based articles.…”

Section: Methodsmentioning

confidence: 99%

Five-year outcomes after surgery for class 1 obesity: a retrospective analysis of a Canadian bariatric centre’s experience

Studer

Magdy

Bacon

et al. 2022

cjs

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Background: There is a paucity of literature exploring the role of bariatric surgery in class 1 obesity. We evaluated the 5-year outcomes after bariatric surgery in patients with class 1 obesity, assessing weight loss, resolution/reduction of obesity-related comorbidities, morbidity and mortality. Methods: We performed a single-centre retrospective analysis of patients who underwent bariatric surgery (laparoscopic sleeve gastrectomy [LSG] or laparoscopic Roux-en-Y gastric bypass [LRYGB)]) for class 1 obesity (body mass index [BMI] 30.0–34.9) between January 2012 and February 2019. Results: Thirty-seven patients (35 [95%] female, mean age 44.5 yr [standard error (SE) 11.3 yr], mean preoperative BMI 33.1) were included, of whom 32 underwent LSG and 5 underwent LRYGB. Thirty-five patients were followed for 5 years post-operatively, achieving a mean BMI of 25.6 (SE 1.2) and excess weight loss of 89.4% (SE 15.1%). Remission of hypertension was achieved in 5 of 12 patients (42%), and remission of dyslipidemia was achieved in 7 of 11 patients (64%). Of the 11 patients with diabetes, 7 underwent LSG and 4, LRYGB. At 5 years postoperatively, the mean glycosylated hemoglobin concentration was 6.3%. Four patients in the LSG group developed de novo reflux, 1 patient required conversion to LRYGB, and 1 patient with sleeve stenosis required endoscopic dilatation. There were no deaths in either patient group. Conclusion: At our centre, bariatric surgery for class 1 obesity was safe and had long-term efficacy, with remission or reduction of related comorbidities. Prospective controlled trials are required to confirm these results.

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The fate of laparoscopic adjustable gastric band removal

Cited by 18 publications

References 22 publications

Feasibility and Short-Term Outcomes of One-Step and Two-Step Sleeve Gastrectomy as Revision Procedures for Failed Adjustable Gastric Banding Compared With Those After Primary Sleeve Gastrectomy

Feasibility and Short-Term Outcomes of One-Step and Two-Step Sleeve Gastrectomy as Revision Procedures for Failed Adjustable Gastric Banding Compared With Those After Primary Sleeve Gastrectomy

Safety and short-term outcomes of sleeve gastrectomy and Roux-en-Y gastric bypass following removal of adjustable gastric banding

Five-year outcomes after surgery for class 1 obesity: a retrospective analysis of a Canadian bariatric centre’s experience

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