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Obeid NR, Gibbs KE, Faler B, Eckhouse S, Corcelles R, Alvarez R, Chen J, Husain F, Ghanem OM, Kroh M, Kurian M. The SAGES MASTERS program bariatric surgery pathway selects 10 seminal publications on adjustable gastric banding. Surg Endosc 2024; 38:2964-2973. [PMID: 38714569 DOI: 10.1007/s00464-024-10812-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/21/2024] [Indexed: 05/10/2024]
Abstract
BACKGROUND Bariatric surgery is one of the clinical pathways of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Masters Program, and laparoscopic adjustable gastric banding (LAGB) is one of the three anchoring bariatric procedures. To improve surgeon lifelong learning, the Masters Program seeks to identify sentinel articles of each of the 3 bariatric anchoring procedures. In this article, we present the top 10 articles on LAGB. METHODS A systematic literature search of papers on LAGB was completed, and publications with the most citations and citation index were selected and shared with SAGES Metabolic and Bariatric Surgery Committee members for review. The individual committee members then ranked these papers, and the top 10 papers were chosen based on the composite ranking. RESULTS The top 10 sentinel publications on LAGB contributed substantially to the body of literature related to the procedure, whether for surgical technique, novel information, or outcome analysis. A summary of each paper including expert appraisal and commentary is presented here. CONCLUSION These seminal articles have had significant contribution to our understanding and appreciation of the LAGB procedure. Bariatric surgeons should use this resource to enhance their continual education and acquisition of specialized skills.
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Affiliation(s)
- Nabeel R Obeid
- Department of Surgery, Michigan Medicine, Ann Arbor, MI, USA.
| | - Karen E Gibbs
- Department of Surgery, Yale Medicine, New Haven, CT, USA
| | - Byron Faler
- Department of Surgery, Dwight D. Eisenhower Army Medical Center, Fort Eisenhower, GA, USA
| | | | | | - Rafael Alvarez
- Department of Surgery, Mosaic Life Care, St Joseph, MO, USA
| | - Judy Chen
- Department of Surgery, University of Washington Medicine, Seattle, WA, USA
| | - Farah Husain
- Department of Surgery, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Omar M Ghanem
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Matthew Kroh
- Department of Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Marina Kurian
- Department of Surgery, New York University Langone Health, New York, NY, USA
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Zhao W, Gao W, Li D, Jin L, Wu X, Liu H, Wang L, Zhao Y, Liu X, Chen P, Dong G. Management of esophagogastric fistula caused by adjustable gastric band erosion: A case report and literature review. Obes Res Clin Pract 2023; 17:428-431. [PMID: 37739856 DOI: 10.1016/j.orcp.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/24/2023]
Abstract
Laparoscopic adjustable gastric banding (LAGB) is commonly used in the treatment of morbid obesity. However, with clinical application and long-term follow-up, the shortcomings of this procedure were also exposed, bringing about surgery-related complications include dysphagia, intragastric band migration, slippage, and gastric band erosion. Lower esophageal and gastric fistula is a rare but dangerous complication after LAGB. We describe a case of esophagogastric fistula occurring twelve years after a laparoscopic band procedure and its successful management in a multidisciplinary and staged manner, followed by a short review of the literature.
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Affiliation(s)
- Wen Zhao
- School of Medicine, Nankai University, Tianjin 300071, China; Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Wenxing Gao
- Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing, China
| | - Dingchang Li
- Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing, China
| | - Lujia Jin
- Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing, China
| | - XianSheng Wu
- Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Hao Liu
- School of Medicine, Nankai University, Tianjin 300071, China; Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Lei Wang
- Medical School of Chinese PLA, Beijing, China; Department & Institute of Urology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Yingjie Zhao
- Department & Institute of General Surgery, the Eighth Medical Center of Chinese PLA General Hospital, Beijing 100091, China
| | - Xianqiang Liu
- Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing, China
| | - Peng Chen
- Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing, China.
| | - Guanglong Dong
- School of Medicine, Nankai University, Tianjin 300071, China; Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
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Common, Less Common, and Unexpected Complications after Bariatric Surgery: A Pictorial Essay. Diagnostics (Basel) 2022; 12:diagnostics12112637. [DOI: 10.3390/diagnostics12112637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
Bariatric surgery has demonstrated a higher rate of success than other nonsurgical treatments in selected patients with obesity; however, like all medical procedures, postoperative complications may occur, ranging between 2 and 10% and, although rare, they can be life threatening. Complications may be unspecific (any surgery-related complications) or specific (linked to the specific surgical procedure) and can be distinguished as common, less common, and unexpected. According to the onset, they may be acute, when occurring in the first 30 days after surgery, or chronic, with a presentation after 30 days from the procedure. The aim of this pictorial essay is to review the radiological aspects of surgical techniques usually performed and the possible complications, in order to make radiologists more confident with the postsurgical anatomy and with the normal and abnormal imaging findings.
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Ahmed S, Pouwels S, Parmar C, Kassir R, de Luca M, Graham Y, Mahawar K. Outcomes of Bariatric Surgery in Patients with Liver Cirrhosis: a Systematic Review. Obes Surg 2021; 31:2255-2267. [PMID: 33595790 DOI: 10.1007/s11695-021-05289-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/02/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
Obesity is commonly associated with non-alcoholic fatty liver disease and is a significant cause of chronic liver disease and cirrhosis. Some patients undergoing bariatric surgery suffer from cirrhosis of the liver. Currently, there is a lack of consensus on the management of these patients and the safety and efficacy of bariatric surgery in this group. This review aims to update our previously published systematic review on the same topic. A total of 21 studies reporting experience on patients with cirrhosis undergoing bariatric surgery were included. Sleeve gastrectomy was the most common surgery performed, followed by Roux-en-Y gastric bypass. The results show that bariatric surgery may be feasible in carefully selected patients with obesity and cirrhosis although they have slightly higher morbidity and mortality rates.
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Affiliation(s)
- Saleem Ahmed
- Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - Chetan Parmar
- Department of Surgery, University College London Hospital NHS Foundation Trust, London, UK.,Department of Surgery, Whittington Hospital NHS Trust, London, UK
| | - Radwan Kassir
- CHU Félix Guyon, Allée des Topazes, Saint-Denis, France
| | - Maurizio de Luca
- Department of Surgery, Castelfranco and Montebelluna Hospitals, Treviso, Italy
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK.,Bariatric Unit, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK.,Bariatric Unit, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
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Khaitan L, Shea BJ. Laparoscopic vertical sleeve gastrectomy, long and short-term impact on weight loss and associated co-morbidities. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:S5. [PMID: 32309409 PMCID: PMC7154321 DOI: 10.21037/atm.2020.01.89] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The laparoscopic vertical sleeve gastrectomy (LVSG) has become the most popular operation for the treatment of morbid obesity in the United States. Being a purely restrictive procedure, the LVSG works to reduce the caloric intake of patients as well as decrease appetite through removal of ghrelin producing cells. Initially developed as the first part of a combined two step restrictive and malabsorptive procedure, the LVSG developed as a standalone procedure when patients lost significant weight with the restrictive portion of the operation alone. Short term outcomes have been promising in terms of weight loss and resolution of comorbid conditions. Long term outcomes are still evolving, but do demonstrate durable weight loss for a significant number of patients. Concerns with the LVSG in the long term revolve around development or worsening of gastroesophageal reflux disease or weight regain. The LVSG has been demonstrated to be a useful tool in the surgical management of morbid obesity.
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Affiliation(s)
- Leena Khaitan
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Brian J Shea
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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Bains L, Lal P, Vindal A, Gautam K. Weight Regain After LABG: Ponder to Intra-gastric Migration of Adjustable Gastric Band. MAMC JOURNAL OF MEDICAL SCIENCES 2020. [DOI: 10.4103/mamcjms.mamcjms_78_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Technical Details and Result of a Minimally Invasive Management of Gastric Band Erosions: a Series of 47 Patients. Obes Surg 2019; 29:3754-3761. [PMID: 31520303 DOI: 10.1007/s11695-019-04170-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Laparoscopic adjustable gastric banding (LAGB) is proven to be a safe and effective treatment option for obesity in the long term. However, in recent decades, LAGB prevalence progressively decreased worldwide principally due to the incidence and the management of the complications. Understanding the optimal management of the complications becomes therefore of primary importance. The aim of this study is to describe a personal technical, laparoscopic solution of band erosion and to analyze outcomes in 47 patients. METHODS From October 1995 to January 2019, 3697 LAGB were performed at our institution. Since November 2011, an original laparoscopic gastric banding removal technique was introduced. All the bands placed in these patients were Lap-Band AP System (Allergan, Irvin, CA). The data of the patients who underwent gastric band removal because of band erosion were retrieved from a prospectively collected institutional database, and used for the present retrospective evaluation. RESULT Ninety-four patients (2.5% of the entire casuistic) with eroded band were diagnosed and treated at our institution. Forty-seven patients were treated with the laparoscopic gastric banding removal technique introduced in November 2011. All the operations have been performed laparoscopically with no conversion or intraoperative complications. There were neither major complications nor peri-operative (30 days) mortality. CONCLUSION Proper preoperative management and a standardized minimally invasive technique could help to cope with erosion, the most frightening complication of LAGB. Understanding the optimal management of complications and safe reoperation techniques can contribute to a rational use of the LAGB, reversing the current declining tendency.
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Abstract
Obesity is a major health and economic crisis facing the modern world. It is associated with excess mortality and morbidity and is directly linked to common conditions such as type 2 diabetes mellitus, coronary heart disease and sleep apnoea. The management of obesity and its associated complications has evolved in recent years, with a shift towards more definitive strategies such as bariatric surgery. This review encompasses the dietary, pharmacological and surgical strategies currently available for the management of obesity.
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Furbetta N, Gragnani F, Flauti G, Guidi F, Furbetta F. Laparoscopic adjustable gastric banding on 3566 patients up to 20-year follow-up: Long-term results of a standardized technique. Surg Obes Relat Dis 2018; 15:409-416. [PMID: 30704912 DOI: 10.1016/j.soard.2018.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/17/2018] [Accepted: 12/06/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND As obesity is a chronic disease, any bariatric procedure should be validated by long-term results. OBJECTIVE To present our long-term results after laparoscopic adjustable gastric banding over a period of >20 years and to investigate the outcomes in terms of efficacy, complications, and reoperations. SETTING Private practice, Italy. METHODS From October 1995 to February 2018, 3566 laparoscopic adjustable gastric banding were performed by a single surgeon. Data were retrieved from a prospectively collected computer database and retrospectively analyzed. Furthermore, patients were stratified according to body mass index and age and results are evaluated for each subgroup. RESULTS All the operations were performed laparoscopically without any mortality and/or major specific complications. Nine hundred twenty-six patients (71.6%) completed at least 10-years follow-up and 180 (58.4%) reached 15-years follow-up. There was a mean of 49%, 52.6%, and 59.2% of excess weight loss at 10, 15, and 20 years, respectively. Major late complications were pouch herniation-dilation (5.8%) and erosion (2.5%), both solved by a replicable, less invasive operation. Total reoperation rate was 24.1%. CONCLUSION Our experience suggested that the combination of a standardized surgical technique and close patient follow-up, performed in collaboration with an interdisciplinary team, may make the laparoscopic adjustable gastric banding system a powerful long-term surgical tool in the treatment of morbid obesity. The best results were obtained in young patients with high body mass index but results were also satisfactory in elderly patients and in those with low body mass index.
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Affiliation(s)
- Niccolò Furbetta
- General Surgery, Department of Surgery, University of Pisa, Pisa, Italy.
| | - Francesca Gragnani
- General and laparoscopic Surgery, Clinic "Leonardo," Sovigliana-Vinci (Firenze), Italy
| | - Giuseppe Flauti
- General and laparoscopic Surgery, Clinic "Leonardo," Sovigliana-Vinci (Firenze), Italy
| | - Francesco Guidi
- Anesthesiologist, Clinic "Leonardo," Sovigliana-Vinci (Firenze), Italy
| | - Francesco Furbetta
- General and laparoscopic Surgery, Clinic "Leonardo," Sovigliana-Vinci (Firenze), Italy
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Abstract
BACKGROUND Laparoscopic adjustable gastric banding (LAGB) placements have progressively decreased in recent years. This is related to poor long-term weight loss outcomes and necessity for revision or removal of these bands. Long-term outcome results following LAGB are limited. The aim of our study was to determine the long-term outcome after LAGB at our institution. OBJECTIVES The aim of our study was to determine the long-term outcome after LAGB at our institution. SETTING The setting of this is Academic Center, Israel. METHODS Patients who underwent LAGB between 1999 and 2004 were reviewed. Patient comorbidities and weight loss parameters were collected preoperatively and at defined postoperative periods. Improvement in weight loss was defined as percent excess weight lost, and improvement in comorbidities was defined based on standardized reporting definitions. RESULTS In total, 74 (80%) patients who underwent LAGB met inclusion criteria. The mean age at LAGB placement was 50.5 ± 9.6 years, and the mean body mass index (BMI) was 45.5 ± 4.8 kg/m2. Preoperative comorbidities were diabetes mellitus (13.5%), hypertension (32%), hyperlipidemia (12.1%), obstructive sleep apnea (5.4%), joints disease (10.8%), mood disorders (5.4%), and gastro-esophageal reflux disease (GERD) symptoms (8.1%). The mean follow-up was 162.96 ± 13.9 months; 44 patients (59.4%) had their band removed, and 22 (30%) had another bariatric surgery. The follow-up BMI was 35.7 ± 6.9 (p < 0.001), and the % total weight loss was 21.0 ± 0.13. There was no improvement in any of the comorbidities. GERD symptoms worsened at long-term follow-up (p < 0.001). Undergoing another bariatric procedure was associated with a higher weight loss (OR 12.8; CI 95% 1.62-23.9; p = 0.02). CONCLUSION LAGB required removal in the majority of our patients and showed poor resolution of comorbidities with worsening of GERD-related symptoms. Patients who go on to have another bariatric procedure have more durable weight loss outcomes.
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Noel P, Nedelcu AM, Eddbali I, Zundel N. Laparoscopic vertical clip gastroplasty – quality of life. Surg Obes Relat Dis 2018; 14:1587-1593. [PMID: 30449515 DOI: 10.1016/j.soard.2018.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 07/08/2018] [Accepted: 07/16/2018] [Indexed: 02/07/2023]
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Clayton RD, Carucci LR. Imaging following bariatric surgery: roux-en-Y gastric bypass, laparoscopic adjustable gastric banding and sleeve gastrectomy. Br J Radiol 2018; 91:20180031. [PMID: 29869916 PMCID: PMC6223156 DOI: 10.1259/bjr.20180031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 05/29/2018] [Accepted: 05/30/2018] [Indexed: 12/13/2022] Open
Abstract
Morbid obesity is an increasing health problem, and bariatric surgery is a popular treatment option. Radiologists must be familiar with performing and interpreting studies in this patient population. The typical post-operative findings of the Roux-en-Y gastric bypass (RYGB), laparoscopic adjustable gastric banding (LAGB) and sleeve gastrectomy (SG) procedures on upper gastrointestinal (UGI) series and computerized tomography (CT) are presented. An overview of the potential complications is provided in addition to a description of potential pitfalls in interpreting these studies.
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Affiliation(s)
- Ryan D Clayton
- Department of Radiology, VCU Health System, Richmond, VA, USA
| | - Laura R Carucci
- Department of Radiology, VCU Health System, Richmond, VA, USA
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Docimo S, Svestka M. Endoscopic Evaluation and Treatment of Postoperative Bariatric Surgery Complications. Surg Innov 2017; 24:616-624. [PMID: 29072533 DOI: 10.1177/1553350617736651] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The number of patients undergoing bariatric surgery continues to increase. The American Society for Metabolic and Bariatric Surgery (ASMBS) estimates the number of bariatric surgical procedures performed increased from 158 000 in 2011 to 190 000 in 2015. Concurrently, the incidence of postoperative complications specific to bariatric patients will inevitably increase as well. Endoscopic evaluation of postoperative bariatric patients and endoscopic interventions are rapidly evolving. We present a review of the postoperative anatomy of bariatric patients, what complications to expect, and treatment options.
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Long-term outcome of laparoscopic adjustable gastric banding (LAGB): results of a Swiss single-center study of 405 patients with up to 18 years' follow-up. Surg Obes Relat Dis 2017; 13:1313-1319. [PMID: 28602794 DOI: 10.1016/j.soard.2017.04.030] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 04/17/2017] [Accepted: 04/22/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND In the past, laparoscopic adjustable gastric banding (LAGB) seemed to be a promising bariatric procedure. However, many studies showed high rates of reoperation due to complications or insufficient weight loss. There is a lack of long-term studies with follow-up beyond 15 years. OBJECTIVE To conduct long-term follow-up of patients after LAGB and analyze their weight loss as a primary endpoint. SETTING Tertiary referral center for bariatric surgery, St. Claraspital, Switzerland. METHODS A retrospective analysis of prospectively collected clinical data in a cohort of 405 patients having undergone LAGB was performed. RESULTS A total of 405 patients (age 41±10 years, body mass index [BMI] 44.3±6 kg/m2) were treated with LAGB between 1996 and 2010. Mean follow-up was 13±3 years, with a follow-up rate of 85% (range 8-18 years), corresponding to 343 patients. One hundred patients exceeded 15-year follow-up. In 216 patients (63%), sleeve gastrectomy, gastric bypass, or biliopancreatic diversion with duodenal switch was performed as revisional surgery. Twenty-seven patients (8%) refused revisional surgery after band removal. Finally, 100 patients (29%) still have the band in place, with a mean BMI of 35±7 kg/m2, corresponding to an excess BMI loss of 48±27%. Among these, the failure rate was 25%, according to the Bariatric Analysis and Reporting Outcome System (BAROS); 50% had a good to excellent outcome. CONCLUSION More than 10 years after LAGB, 71% of patients lost their bands and only 15% of the 343 followed patients with the band in place have a good to excellent result, according to BAROS.
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Impact of Surgical Technique on Long-term Complication Rate After Laparoscopic Adjustable Gastric Banding (LAGB). Ann Surg 2016; 264:738-744. [DOI: 10.1097/sla.0000000000001835] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Juodeikis Ž, Abalikšta T, Brimienė V, Brimas G. Laparoscopic Adjustable Gastric Banding: a Prospective Randomized Clinical Trial Comparing 5-Year Results of two Different Bands in 103 Patients. Obes Surg 2016; 27:1024-1030. [PMID: 27730462 DOI: 10.1007/s11695-016-2416-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Various types of adjustable gastric bands are used during LAGB, but there is insufficient data comparing different bands in the long term. We carried out a prospective randomized study to compare two different bands. METHODS Between January 1, 2009 and January 31, 2010, 103 morbidly obese patients were randomized between SAGB and MiniMizer Extra adjustable gastric bands. The SAGB was used in 49 and MiniMizer Extra in 54 patients. Weight loss, comorbidities, long-term complications, and quality of life were evaluated after 5 years. RESULTS Patient baseline characteristics were similar in the two groups. The mean patient age was 45.9 ± 11.7 years, and mean preoperative BMI was 47.5 ± 7.3 kg/m2. A total of 90 of 103 patients (87.3 %) completed the 5-year follow-up. The mean excess weight loss was 44.1 and 50.3 % in SAGB and MiniMizer groups, respectively (p = 0.14). A proportion of patients who reached a BMI < 35 kg/m2 was significantly larger in MiniMizer Extra group (52.9 vs 25.5 %; p = 0.01). Complications developed in 15 patients (14.5 %) and consisted of 5 band erosions, 4 port-related complications, 3 band slippages, and 3 band intolerances. All five band erosions developed in MiniMizer Extra group, but the difference was not significant (p = 0.058). No difference was found regarding postoperative complications, resolution of comorbidities, and quality of life between compared groups. CONCLUSIONS SAGB and MiniMizer Extra bands demonstrated similar long-term results regarding the weight loss, resolution of comorbidities, morbidity, and quality of life.
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Affiliation(s)
- Žygimantas Juodeikis
- Vilnius University, Vilnius, Lithuania. .,Republican Vilnius University Hospital, Šiltnamių str. 29, LT-04130, Vilnius, Lithuania.
| | - Tomas Abalikšta
- Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania
| | - Vilma Brimienė
- Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania
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Collado-Pacheco D, Rábago-Torre LR, Arias-Rivera M, Ortega-Carbonel A, Olivares-Valles A, Alonso-Prada A, Vázquez-Echarri J, Herrera-Merino N. Endoscopic extraction of adjustable gastric bands after intragastric migration as a complication of bariatric surgery: technique and advice. Endosc Int Open 2016; 4:E673-7. [PMID: 27556077 PMCID: PMC4993909 DOI: 10.1055/s-0042-105868] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 03/14/2016] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Surgery has been the method most widely used to manage the extraction of gastric bands with inclusion as a late complication of bariatric surgery; however, surgical extraction entails morbidity and limits future surgical procedures. The development of endoscopic techniques has provided an important means of improving the treatment of this complication, enabling minimally invasive and safe procedures that have a high success rate. METHODS A retrospective analysis was conducted of patients who had laparoscopic gastric banding complicated by intragastric migration and were treated endoscopically. A technique already described for managing this complication was employed. An MTW Endoskopie Dormia basket for mechanical lithotripsy or a standard 0.0035-in guidewire was placed around the band, and an MTW Endoskopie emergency lithotripter was used to section it, after which the band was extracted with a standard polypectomy snare. Also analyzed were the initial symptoms of patients with this complication, the mean time from surgery to development of the event, the success rate of endoscopic treatment, and complications, Results: A total of 127 patients had undergone gastric banding surgery in our Bariatric Surgery Center; of these, 12 patients (9.4 %) developed a complication such as intragastric migration of the band. Weight gain and pain were the main symptoms in 11 patients (92 %), and the mean time to the development of symptoms was 51.3 months. A single endoscopic treatment was successful in 7 of 9 patients (78 %). Only 1 complication, involving ventilation during anesthesia, occurred; no other adverse events were recorded. CONCLUSIONS The endoscopic extraction of bands with inclusion is feasible and can be performed easily and successfully. The procedure is available in all hospitals and has a low incidence of related complications, so that unnecessary surgical procedures can be avoided.
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Affiliation(s)
| | | | - Maria Arias-Rivera
- Gastroenterology Unit, Hospital Universitario Severo Ochoa, Leganés (Madrid), Spain
| | | | - Ana Olivares-Valles
- Gastroenterology Unit, Hospital Universitario Severo Ochoa, Leganés (Madrid), Spain
| | - Alicia Alonso-Prada
- Gastroenterology Unit, Hospital Universitario Severo Ochoa, Leganés (Madrid), Spain
| | - Jaime Vázquez-Echarri
- General and Gastroenterological Surgery Department, Hospital Universitario Severo Ochoa, Leganés (Madrid), Spain
| | - Norberto Herrera-Merino
- General and Gastroenterological Surgery Department, Hospital Universitario Severo Ochoa, Leganés (Madrid), Spain
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Zampieri N, Castellani R, Francia L. Is There Still a Role for Video-Assisted Laparoscopic Gastric Banding in Severe Obesity? Bariatr Surg Pract Patient Care 2016. [DOI: 10.1089/bari.2015.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Nicola Zampieri
- Department of Surgery, University of Verona, AOUI, Verona, Italy
| | - Roberto Castellani
- Department of Surgery, Casa di Cura San Francesco Hospital, Verona, Italy
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Management modalities in slipped gastric band. Surg Obes Relat Dis 2016; 12:714-716. [PMID: 26778237 DOI: 10.1016/j.soard.2015.10.058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 10/04/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Gastric band slippage is one of the possible complications of the laparoscopic gastric band (LGB). Band slippage can present as an emergency and have drastic consequences. We herein report the different treatment modalities of slipped gastric band. MATERIAL AND METHODS A retrospective study of all patients presenting with slipped gastric band between May 2013 and January 2015 at our University hospital is described. All patients were evaluated at the time of presentation by radiological studies and upper gastrointestinal endoscopy. On diagnosis, all bands were deflated in an attempt to relieve symptoms. After patient counseling and band position evaluation, patients were consented for either removal or repositioning of the band. RESULTS This study included 100 patients. Gastric band slippage rate was 8%. All patients presented with signs of gastric obstruction and expressed a long history of intermittent vomiting attacks. All patients were subjected to a complete gastric band deflation on presentation. Band deflation successfully relieved symptoms and reversed band slippage in 2 patients. However, both patients returned with band reslippage within the same month. The other 6 patients had persistent band slippage despite complete band deflation. Three of the 8 patients had a successful band repositioning, and the rest had their gastric bands removed. CONCLUSION Gastric band slippage can be a serious LGB complication. Repeated vomiting can be a significant risk factor for band slippage. Moreover, band repositioning can be a well-tolerated and feasible option in the management of slipped gastric band.
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Echaverry-Navarrete DJ, Maldonado-Vázquez A, Cortes-Romano P, Cabrera-Jardines R, Mondragón-Pinzón EE, Castillo-González FA. [Gastric band erosion: Alternative management]. CIR CIR 2015; 83:418-23. [PMID: 26164136 DOI: 10.1016/j.circir.2015.05.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 09/04/2014] [Indexed: 10/23/2022]
Abstract
BACKGROUND Obesity is a public health problem, for which the prevalence has increased worldwide at an alarming rate, affecting 1.7 billion people in the world. OBJECTIVE To describe the technique employed in incomplete penetration of gastric band where endoscopic management and/or primary closure is not feasible. MATERIAL AND METHODS Laparoscopic removal of gastric band was performed in five patients with incomplete penetrance using Foley catheterization in the perforation site that could lead to the development of a gastro-cutaneous fistula. CLINICAL CASES The cases presented include a leak that required surgical lavage with satisfactory outcome, and one patient developed stenosis 3 years after surgical management, which was resolved endoscopically. In all cases, the penetration site closed spontaneously. DISCUSSION Gastric band erosion has been reported in 3.4% of cases. The reason for inserting a catheter is to create a controlled gastro-cutaneous fistula, allowing spontaneous closure. CONCLUSIONS Various techniques have been described: the totally endoscopic, hybrid techniques (endoscopic/laparoscopic) and completely laparoscopic. A technique is described here that is useful and successful in cases where the above-described treatments are not viable.
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Affiliation(s)
| | | | - Pablo Cortes-Romano
- Instituto de Obesidad y Síndrome Metabólico, Hospital Ángeles del Pedregal, México, D.F., México
| | - Ricardo Cabrera-Jardines
- Instituto de Obesidad y Síndrome Metabólico, Hospital Ángeles del Pedregal, México, D.F., México
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Shen X, Zhang X, Bi J, Yin K. Long-term complications requiring reoperations after laparoscopic adjustable gastric banding: a systematic review. Surg Obes Relat Dis 2015; 11:956-64. [DOI: 10.1016/j.soard.2014.11.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 11/10/2014] [Accepted: 11/10/2014] [Indexed: 01/27/2023]
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The role of endoscopy in the bariatric surgery patient. Gastrointest Endosc 2015; 81:1063-72. [PMID: 25733126 DOI: 10.1016/j.gie.2014.09.044] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 09/11/2014] [Indexed: 12/22/2022]
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Musielak MC, Patel HK, Curry TW, Fegelman EJ. Laparoscopic Gastric Band Erosion: A Retrospective Analysis and Review of Management. Bariatr Surg Pract Patient Care 2014. [DOI: 10.1089/bari.2014.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Hiral K. Patel
- Department of Surgery, The Jewish Hospital, Cincinnati, Ohio
| | - Trace W. Curry
- Department of Surgery, The Jewish Hospital, Cincinnati, Ohio
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Hussain AA, Nicholls J, El-Hasani SS. Laparoscopic adjustable gastric band: how to reduce the early morbidity. JSLS 2014; 18:JSLS-D-13-00241. [PMID: 25392623 PMCID: PMC4154413 DOI: 10.4293/jsls.2014.00241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Laparoscopic adjustable gastric band insertion is a safe weight reduction procedure, but serious complications can develop. The aim of this study was to evaluate our technique in preventing early band complications. METHODS Patients were given the choice of procedure according to body mass index, the presence of diabetes, and preference. Weight loss data were not considered, as our aim was to evaluate the morbidity of band surgery using a specific technique. A pars flaccida approach and plication technique were used for all patients. Postoperative follow-up was provided at 1 month, 2 months, and every 3 months for the first year and then yearly for a further 2 years. Thereafter, general practitioners referred patients if late complications arose. RESULTS From January 2007 to August 2011, 1149 patients (245 men [21.32%], 904 women [78.67%]) underwent laparoscopic adjustable gastric band insertion under the care of a single bariatric surgeon. Patients were hospitalized for 1 night only unless they developed early complications. The primary and secondary outcomes were major and minor band complications, respectively. Patients' age range was 18 to 64 years (mean, 44 years). Body mass index ranged from 33 to 62 kg/m2 (mean, 42 kg/m2). There were 2 band erosions (0.17%), 6 cases of band prolapse (0.52%), 4 port problems (0.34%), 1 band leak (0.08%), 3 tight bands (0.26%), 2 port infections (0.17%), and no deaths. Five procedures (0.43%) were abandoned and excluded from this study, and 1 (0.17%) was converted to minilaparotomy to control abdominal wall bleeding. The duration of follow-up ranged from 16 to 60 months. CONCLUSIONS A combined pars flaccida and plication technique is associated with a low early complication rate.
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Affiliation(s)
- Abdulzahra A Hussain
- Bariatric Unit, General Surgery Department, Princess Royal University Hospital, Orpington, Greater London, United Kingdom
| | - Jacqueline Nicholls
- Bariatric Unit, University College London Hospitals, Greater London, United Kingdom
| | - Shamsi S El-Hasani
- Bariatric Unit, General Surgery Department, Princess Royal University Hospital, Orpington, Greater London, United Kingdom
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Mathus-Vliegen EMH. The cooperation between endoscopists and surgeons in treating complications of bariatric surgery. Best Pract Res Clin Gastroenterol 2014; 28:703-25. [PMID: 25194185 DOI: 10.1016/j.bpg.2014.07.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 06/18/2014] [Accepted: 07/05/2014] [Indexed: 02/09/2023]
Abstract
The results of lifestyle interventions and pharmacotherapy are disappointing in severe obesity which is characterised by premature death and many obesity-associated co-morbidities. Only surgery may achieve significant and durable weight losses associated with increased life expectancy and improvement of co-morbidities. Bariatric surgery involves the gastrointestinal tract and may therefore increase gastrointestinal complaints. Bariatric surgery may also result in complications which in many cases can be solved by endoscopic interventions. This requires a close cooperation between surgeons and endoscopists. This chapter will concentrate on the most commonly performed operations such as the Roux-en-Y gastric bypass, the adjustable gastric banding and the sleeve gastrectomy, in the majority of cases performed by laparoscopy. Operations such as the vertical banded gastroplasty and the biliopancreatic diversion with or without duodenal switch will not be discussed at length as patients with these operations will not be encountered frequently and their management can be found under the headings of the other operations.
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Affiliation(s)
- E M H Mathus-Vliegen
- Academic Medical Centre, University of Amsterdam, Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
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JOURNAL CLUB: Gastric Band Slippage: A Case-Controlled Study Comparing New and Old Radiographic Signs of This Important Surgical Complication. AJR Am J Roentgenol 2014; 203:10-6. [DOI: 10.2214/ajr.13.11650] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Simultaneous Gastric and Duodenal Erosions due to Adjustable Gastric Banding for Morbid Obesity. Case Rep Surg 2014; 2014:146980. [PMID: 24883218 PMCID: PMC4026868 DOI: 10.1155/2014/146980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 04/26/2014] [Indexed: 11/17/2022] Open
Abstract
Erosion is an uncommon but feared late complication of adjustable gastric banding for morbid obesity. A high index of clinical suspicion is required, since symptoms are usually vague and nonspecific. Diagnosis is confirmed on upper gastrointestinal endoscopy and band removal is the mainstay of treatment, with band revision or conversion to other bariatric modalities at a later stage. Duodenal erosion is a much rarer complication, caused by the connection tubing of the band. We present our experience with a case of simultaneous gastric and duodenal erosions, managed by laparoscopic explantation of the band, primary suture repair of the duodenum, and omentopexy.
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Rodarte-Shade M, Barrera GT, Arredondo JFH, Diaz RR. Hybrid technique for removal of eroded adjustable gastric band. JSLS 2013; 17:338-41. [PMID: 23925033 PMCID: PMC3771806 DOI: 10.4293/108680813x13654754534279] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A hybrid technique of laparoscopy and endoscopy can be successful in removal of eroded gastric bands. Background: Intragastric migration is a late and rare postsurgical complication in patients with gastric band placement. Gastric band erosion rate has previously been described to be 1.46%. In this report, we present the case of a 43-y-old male with gastric band erosion undergoing a laparoendoscopic retrieval of the gastric band, due to intragastric migration. Method: A hybrid procedure was performed to retrieve the gastric band. A laparoscopic approach was initially used to extract the connecting tube. Endoscopy was then performed to cut the gastric band with a specific cutter system and was subsequently extracted transorally. Results: The postoperative course was uneventful. Clear liquids were started on day 1, and the patient was discharged on day 2. Discussion: The purpose of this study was to describe a hybrid technique for the removal of an eroded gastric band, as a safe and feasible option in patients with band erosions. Conclusion: The laparoscopic approach enables safe extraction of the connecting tube, while endoscopy allows extraction of the band without creating a large incision in the stomach.
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Affiliation(s)
- Mario Rodarte-Shade
- Department of Surgery, Instituto Tecnologico y de Estudios Superiores de Monterrey, Mexico.
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Garrido D, Bush LM. Liver abscess as a complication of laparoscopic gastric banding bariatric surgery. Surg Infect (Larchmt) 2013; 14:464-9. [PMID: 23862560 DOI: 10.1089/sur.2012.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The World Health Organization has identified the rapidly growing prevalence of obesity as one of today's serious health problems. Various surgical interventions categorized collectively as bariatric surgery now play an ever-increasing important role as the only known effective treatment for severe obesity. Laparoscopic gastric bypass is currently the most frequent bariatric surgical procedure performed. However, the laparoscopic adjustable gastric band (LAGB) is rapidly gaining in popularity as a minimally invasive surgical option with anticipated similarly efficacious outcomes. Gastric band erosion following LAGB is an uncommon yet potentially serious complication unique to this form of weight loss surgery. METHODS Case report and literature review. RESULTS We report a case of a pyogenic liver abscess related to a LAGB procedure. Apropos to this case, we review the presumed pathophysiologic mechanism of this particular infectious process, and discuss this and other complications associated with LAGB operations. CONCLUSIONS As LAGB bariatric procedures become more popular, clinicians need to be aware of uncommon, but potentially serious complications unique to this form of weight loss surgery.
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Affiliation(s)
- Danon Garrido
- 1 University of Miami Miller School of Medicine , JFK Medical Center, Atlantis, Florida
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Nanni G, Familiari P, Mor A, Iaconelli A, Perri V, Rubino F, Boldrini G, Salerno MP, Leccesi L, Iesari S, Sollazzi L, Perilli V, Castagneto M, Mingrone G, Costamagna G. Effectiveness of the Transoral Endoscopic Vertical Gastroplasty (TOGa®): a good balance between weight loss and complications, if compared with gastric bypass and biliopancreatic diversion. Obes Surg 2013; 22:1897-902. [PMID: 23001571 DOI: 10.1007/s11695-012-0770-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The effectiveness of restrictive procedures has been inferior to that of malabsorbitive ones. Recent variants of restrictive procedures, i.e., gastric banding and sleeve gastrectomy, confirm the strive for more efficacious solutions with less complications. We investigated the balance between effectiveness and complications for a new restrictive procedure, a Transoral Endoscopic Vertical Gastroplasty (TOGa®) METHODS Seventy-nine morbidly obese patients were submitted to one out of three surgical procedures: TOGa® (29 patients), laparoscopic gastric bypass (LRYGBP; 20 patients), and biliopancreatic diversion (BPD; 30 patients). Mean BMI were 41.7 (35.4-46.6), 44.8 (36.4-54), and 47.5 (41-60.3), respectively. All the patients reached a 2-year follow-up. RESULTS In TOGa® group BMI, respectively at 12 and 24 months, was 34.5 and 35.5, with 44 and 48.3% of patients with BMI lower than 35. In LRYGBP group, BMI was 30.7 and 29.2 kg/m(2), with 80 and 85% of patients with BMI < 35. In BPD group, BMI was 30 and 29.6 kg/m(2), with 100 and 93.3% of patients with BMI < 35. In TOGa® group, 59% of patients with an initial BMI < 45 reached a BMI < 35, in comparison to 48% recorded in the whole group and to 14.3% in patients with initial BMI ≥ 45. CONCLUSIONS In selected patients, TOGa®, was associated with good results after two years in terms of weight loss, even in comparison with LRYGBP and BPD. Minimal trauma, absence of complications, and short hospital stay justify this procedure for patients with low BMI.
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Affiliation(s)
- Giuseppe Nanni
- Department of Surgery, Catholic University, Rome, Italy.
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Exploration of esophageal hiatus: does crural repair reduce proximal pouch distension? Surg Obes Relat Dis 2013; 9:350-5. [DOI: 10.1016/j.soard.2011.12.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 11/25/2011] [Accepted: 12/27/2011] [Indexed: 11/24/2022]
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Kumar N, Thompson CC. Endoscopic management of complications after gastrointestinal weight loss surgery. Clin Gastroenterol Hepatol 2013; 11:343-53. [PMID: 23142331 DOI: 10.1016/j.cgh.2012.10.043] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 10/23/2012] [Accepted: 10/26/2012] [Indexed: 02/07/2023]
Abstract
As more patients undergo bariatric surgery, gastroenterologists will increasingly encounter variant postsurgical anatomies and postoperative complications. We discuss the diagnosis and management of bleeding, ulcers, foreign bodies, stenoses, leaks, fistulas, pancreaticobiliary diseases, weight regain, and dilated outlets.
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Affiliation(s)
- Nitin Kumar
- Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
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36
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Risk of Gastric Pouch Enlargement With Adjustable Gastric Banding in Premenopausal Women. Ann Surg 2013; 257:456-61. [DOI: 10.1097/sla.0b013e3182504665] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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O'Brien P. Comment on: Outcome of laparoscopic adjustable gastric banding and the prevalence of band revision and explantation at academic centers: 2007-2009. Surg Obes Relat Dis 2012; 8:727-8. [DOI: 10.1016/j.soard.2011.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 10/03/2011] [Indexed: 11/15/2022]
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Owers C, Ackroyd R. A Study Examining the Complications Associated with Gastric Banding. Obes Surg 2012; 23:56-9. [DOI: 10.1007/s11695-012-0760-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Pfeiffer JD, Grant J, Lutfi RE. Transanal protrusion of gastric band tubing: a rare complication of laparoscopic adjustable gastric banding. Surg Obes Relat Dis 2012; 9:e23-4. [PMID: 22959471 DOI: 10.1016/j.soard.2012.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 07/30/2012] [Accepted: 07/30/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Joshua D Pfeiffer
- University of Illinois at Chicago, Metropolitan Group Hospitals, Chicago, Illinois 60657, USA.
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Jackson TD, Hutter MM. Morbidity and Effectiveness of Laparoscopic Sleeve Gastrectomy, Adjustable Gastric Band, and Gastric Bypass for Morbid Obesity. Adv Surg 2012; 46:255-68. [DOI: 10.1016/j.yasu.2012.05.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
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Pristed SG, Fromholt J, Kroustrup JP. Relationship Between Morbidly Obese Subjects' Attributions of Low General Well-being, Expectations and Health-Related Quality of Life: Five-year Follow-up After Gastric Banding. APPLIED RESEARCH IN QUALITY OF LIFE 2012; 7:281-294. [PMID: 22924085 PMCID: PMC3411283 DOI: 10.1007/s11482-011-9163-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 11/08/2011] [Indexed: 06/01/2023]
Abstract
Low health-related quality of life among morbidly obese subjects is well-known. However, the relationship may not be simple. We aim to examine the association between pre-operative expectations and health-related quality of life and long-term changes in health-related quality of life after gastric banding. The questionnaires were answered twice: before and five years after gastric banding. Short Form-36 assessed health-related quality of life. Obesity specific questions were used to assess the subjects' attribution of impairment to morbid obesity and their expectations to changes as a result of weight loss. The subjects attribute morbid obesity as a major reason for their impairments in state of health, physical activity, pain and work capacity. As a result of weight loss, the subjects expect improvements even within fields which they did not consider to be impaired due to morbid obesity. We found an inverse association between high expectations and mental component summary score at baseline. At follow-up having expectations fully fulfilled was associated with a higher mental component summary score than having expectations fulfilled only to a fair extension and not having expectations fulfilled. Physical component summary was statistically significant improved at follow-up Morbidly obese subjects' attributions of low general well-being combined with their expectations may be a central part of understanding the mechanisms involved in the association between morbid obesity and low health-related quality of life. Furthermore the impact of morbid obesity on health-related quality of life may be reduced if healthprofessionals bridge the gap between morbidly obese subjects' expectations and their experience.
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Affiliation(s)
- S. G. Pristed
- Department of Endocrinology, Aalborg Hospital – Aarhus University Hospital, Moelleparkvej 4, Medicinerhuset, 9100 Aalborg, Denmark
| | - J. Fromholt
- Department of Surgery, Aalborg Hospital- Aarhus university Hospital, Hobrovej 18-22, 9100 Aalborg, Denmark
- Present Address: The Moelholm Clinic, Brummersvej, 7100 Vejle, Denmark
| | - J. P. Kroustrup
- Department of Endocrinology, Aalborg Hospital – Aarhus University Hospital, Moelleparkvej 4, Medicinerhuset, 9100 Aalborg, Denmark
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Dixon JB, Straznicky NE, Lambert EA, Schlaich MP, Lambert GW. Laparoscopic Adjustable Gastric Banding and Other Devices for the Management of Obesity. Circulation 2012; 126:774-85. [DOI: 10.1161/circulationaha.111.040139] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- John B. Dixon
- From the Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Nora E. Straznicky
- From the Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
| | | | - Markus P. Schlaich
- From the Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Gavin W. Lambert
- From the Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
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Gastric band slippage at 30 weeks' gestation: diagnosis and laparoscopic management. Surg Obes Relat Dis 2012; 8:366-8. [DOI: 10.1016/j.soard.2012.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Revised: 12/27/2011] [Accepted: 01/04/2012] [Indexed: 11/23/2022]
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A 5-year experience with laparoscopic adjustable gastric banding--focus on outcomes, complications, and their management. Obes Surg 2012; 21:1682-6. [PMID: 21618063 DOI: 10.1007/s11695-011-0453-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Laparoscopic adjustable gastric banding (LAGB) remains the most popular surgical modality for obesity management in Europe. The aim of this publication is to present a 5-year experience in obesity treatment with LAGB operation with the assessment of outcomes, frequency of complications, and their management. Management of the band-related complications is crucial for continuous obesity treatments, despite the fact of initial failure, allowing further excess weight loss in patients with morbid obesity. METHODS One hundred sixty patients underwent the LAGB procedure with standard pars flaccida technique during the years 2005-2009. A retrospective analysis of the data was performed; chi-squared test and Student's t test at the level of significance of p < 0.05 were used. Information on reoperations was gathered from hospital case notes. RESULTS In the presented group, the mean body mass index (BMI) was 48.13 kg/m(2) (33.46-83.04 kg/m(2); standard deviation [SD] ±8.45). Of the patients, 36.2% had super morbid obesity with BMI >50 kg/m(2). The mean observation period reached 549 days (31-2,026 days; SD ±390.1), with the mean number of control visits of 4.2 (1-12). The mean percentage of excess weight loss during the observation period was 34% (from -9.9% to 85.1%; SD ±20.6), with the mean body mass reduction of 24.4 kg. Complications appeared in 30 patients (20.1%). Twenty-four patients (16.1%) required reoperation. There were no mortalities recorded. CONCLUSIONS The mean operative time of 59 min was relatively short. Morbidity and mortality rates were comparable to many published series. Failure or complications of LAGB did not stop the obesity treatment. Most of the band-related complications occurred late and could be provided for laparoscopically.
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Dixon JB, Murphy DK, Segel JE, Finkelstein EA. Impact of laparoscopic adjustable gastric banding on type 2 diabetes. Obes Rev 2012; 13:57-67. [PMID: 21880108 DOI: 10.1111/j.1467-789x.2011.00928.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Bariatric surgery is becoming an accepted option for obese people with type 2 diabetes. Our aim was to assess the impact of laparoscopic adjustable gastric banding (LAGB) through a systematic review of the literature. Data was sourced from Scopus, MEDLINE and EMBASE published from 2000 through May 2011, and five unpublished studies that were performed by industry for regulatory approval were also included. Studies were selected on the basis that they provide some detail of diabetes status before and after LAGB. There were 35 studies meeting the inclusion criteria. There was considerable heterogeneity in study design, sample size, length of follow-up, attrition rates and classification of diabetes status. Weight loss was progressive over the first 2 years with a weighted average of 47% excess weight loss at 2 years. Remission or improvement in diabetes varied from 53% to 70% over different time periods. Results were broadly consistent, demonstrating clinically relevant improvements in diabetes outcomes with sustained weight loss in obese people with type 2 diabetes following LAGB surgery. However, there were significant shortcomings in the reviewed literature with few high-quality studies, inconsistent reporting of diabetes outcomes and high attrition rates. Long-term studies that address these limitations are needed.
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Affiliation(s)
- J B Dixon
- Obesity Research Unit, School of Primary Care Monash University, Melbourne, Australia.
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Nguyen NT, Hohmann S, Nguyen XM, Elliott C, Masoomi H. Outcome of laparoscopic adjustable gastric banding and prevalence of band revision and explantation at academic centers: 2007-2009. Surg Obes Relat Dis 2011; 8:724-7. [PMID: 22030147 DOI: 10.1016/j.soard.2011.09.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 08/03/2011] [Accepted: 09/07/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND Laparoscopic adjustable gastric banding is gaining in popularity in the United States. Our objective was to examine the outcomes of laparoscopic adjustable gastric banding and the prevalence of band revision and explantation at academic medical centers. METHODS Using the "International Classification of Diseases, 9th revision," diagnosis and procedure codes, data were obtained from the University Health System Consortium Clinical Database for all laparoscopic adjustable gastric banding procedures performed from 2006 to 2009. The outcome measures included demographics, length of hospital stay, perioperative morbidity, mortality, and the prevalence of band revision and explantation. RESULTS A total of 10,151 laparoscopic gastric banding procedures were performed from January 2007 to December 2009. The mean length of stay was 1.2 days. The perioperative morbidity rate was 3.0%, and the in-hospital mortality rate was .03%. The prevalence of band revision was .76% and of band explantation was .87%. Compared with the outcome of primary gastric banding, gastric band revision or explantation was associated with a longer length of hospital stay, greater perioperative morbidity, and greater cost. CONCLUSION Within the context of the 3-year period of analysis, laparoscopic gastric banding was associated with low perioperative morbidity and mortality and a low prevalence of band revision and explantation.
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Affiliation(s)
- Ninh T Nguyen
- Department of Surgery, University of California, Irvine, Medical Center, Orange, California 92868, USA.
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Dixon JB, Straznicky NE, Lambert EA, Schlaich MP, Lambert GW. Surgical approaches to the treatment of obesity. Nat Rev Gastroenterol Hepatol 2011; 8:429-37. [PMID: 21727936 DOI: 10.1038/nrgastro.2011.112] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Bariatric surgery, through its efficacy and improved safety, is emerging as an important and broadly available treatment for people with severe and complex obesity that has not responded adequately to other therapy. Established procedures, such as Roux-en-Y gastric bypass and adjustable gastric banding, account for more than 80% of bariatric surgical procedures globally. Sleeve gastrectomy has emerged as a stand-alone procedure. Truly malabsoptive procedures, such as biliopancreatic diversion and its duodenal switch variant, have a diminishing role as primary procedures, but remain an option for patients who do not respond adequately to less disruptive procedures. The procedures vary considerably in their postoperative morbidity and mortality; pattern and extent of weight loss; nature and severity of long-term complications; and nutritional requirements and risks. There is no perfect procedure--an informed risk and benefit assessment should be made by each patient. Gastroenterologists also need to be familiar with the risks and benefits of current and emerging procedures as they are likely to be increasingly involved in the integrated care of these patients.
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Affiliation(s)
- John B Dixon
- Baker IDI Heart & Diabetes Institute, PO Box 6492 St. Kilda Road Central, Melbourne, Vic 3004, Australia.
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Abstract
The prevalence of obesity has reached epidemic proportions. Conceptualization of obesity as a chronic disease facilitates greater understanding its treatment. The NIH Consensus Conference on Gastrointestinal Surgery for Severe Obesity provides a framework by which to manage the severely obese--specifically providing medical versus surgical recommendations which are based on scientific and outcomes data. Medical treatments of obesity include primary prevention, dietary intervention, increased physical activity, behavior modification, and pharmacotherapy. Surgical treatment for obesity is based on the extensive neural-hormonal effects of weight loss surgery on metabolism, and as such is better termed Metabolic Surgery. Surgery is not limited to the procedure itself, it also necessitates thorough preoperative evaluation, risk assessment, and counseling. The most common metabolic surgical procedures include Roux-en-Y gastric bypass, adjustable gastric band, sleeve gastrectomy, and biliopancreatic diversion. Surgical outcomes for metabolic surgery are well studied and demonstrate superior long-term weight loss compared to medical management in cases of severe obesity.
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Affiliation(s)
- Nicole A Kissane
- Harvard Medical School, Division of General and Gastrointestinal Surgery, Massachusetts General Hospital, WACC 460, 15 Parkman Street, Boston, MA 02114, USA
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