Adjustable gastric banding as revisional bariatric procedure after failed gastric bypass-intermediate results

Marc Bessler*, Amna Daud, Mary F. DiGiorgi, William B. Inabnet, Beth Schrope, Lorraine Olivero-Rivera, Daniel Davis

*Corresponding author for this work

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

Background: Although gastric bypass is the most common bariatric procedure in the United States, it is has been associated with a failure rate of 15% (range 5-40%). The addition of an adjustable gastric band to Roux-en-Y gastric bypass has been reported to be a useful revision strategy in a small series of patients with inadequate weight loss after proximal gastric bypass. Methods: We report on 22 patients who presented with inadequate weight loss or significant weight regain after proximal gastric bypass. All patients underwent revision with the placement of an adjustable silicone gastric band around the proximal gastric pouch. The bands were adjusted at 6 weeks postoperatively and beyond, as needed. Complications and weight loss at the most recent follow-up visit were evaluated. Results: The mean age and body mass index at revision was 41.27 years (range 25-58) and 44.8 ± 6.34 kg/m2, respectively. Patients had experienced a loss of 19%, 27%, 47.3%, 42.3%, 43%, and 47% of their excess weight at 6, 12, 24, 36, 48, and 60 months after the revisional procedure, respectively. Three major complications occurred requiring reoperation. No band erosions have been documented. Conclusion: The results from this larger series of patients have also indicated that the addition of the adjustable silicone gastric band causes significant weight loss in patients with poor weight loss outcomes after gastric bypass. That no anastomosis or change in absorption is required makes this an attractive revisional strategy. As with all revisional procedures, the complication rates appear to be increased compared with a similar primary operation.

Original languageEnglish (US)
Pages (from-to)31-35
Number of pages5
JournalSurgery for Obesity and Related Diseases
Volume6
Issue number1
DOIs
StatePublished - Jan 1 2010

Keywords

  • Adjustable gastric banding
  • Gastric bypass
  • Laparoscopic
  • Morbid obesity
  • Revision

ASJC Scopus subject areas

  • Surgery

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