BACKGROUND: Re-operations after laparoscopic adjustable gastric banding operation (LAGB) are band-associated or due to complications of the access-port. Symptoms, diagnostics, operations, and follow-up of patients with re-operations were analyzed. METHODS: Between December 1996 and January 2002, 250 morbidly obese patients were treated with LAGB and prospectively evaluated using a standardized protocol. Since June 2000 the pars flaccida technique was applied, since October 2000 with the new 11-cm Lap-Band. All adjustments of the band were done under radiological control. RESULTS: Of 250 patients, 39 had to be re-operated because of band-associated complications: 27 laparoscopic re-gastric bandings after 12 (3-26) months because of slippage; 6 laparoscopic removals of the band (band intolerance - 4, pain - 1, pouch dilatation - 1); 12 biliopancreatic diversions with duodenal switch (BPD-DS) after 29 (18-43) months due to pouch and/or esophageal motility disorders (9) or insufficient weight loss (3), in 6 patients after having already performed a re-banding for slippage. 9 revisions of the access-port were done after 6 (2-53) months (disconnection - 3, dislocation - 6). The morbidity of the re-operations was 5.3%: 1 hematoma in the abdominal wall and 1 temporary dysphagia after re-banding, 1 pulmonary embolism following BPD-DS. There have been no deaths. In patients with a minimal follow-up of 3 years (n = 92), the yearly re-operation rate was 11-12%. No slippage has occurred with the new 11-cm Lap-Band. CONCLUSION: Re-operations after LAGB for band-associated complications were frequent but could be performed safely with little morbidity. When the new 11-cm Lap-Band was employed, the high slippage rate dropped.
BACKGROUND: Re-operations after laparoscopic adjustable gastric banding operation (LAGB) are band-associated or due to complications of the access-port. Symptoms, diagnostics, operations, and follow-up of patients with re-operations were analyzed. METHODS: Between December 1996 and January 2002, 250 morbidly obesepatients were treated with LAGB and prospectively evaluated using a standardized protocol. Since June 2000 the pars flaccida technique was applied, since October 2000 with the new 11-cm Lap-Band. All adjustments of the band were done under radiological control. RESULTS: Of 250 patients, 39 had to be re-operated because of band-associated complications: 27 laparoscopic re-gastric bandings after 12 (3-26) months because of slippage; 6 laparoscopic removals of the band (band intolerance - 4, pain - 1, pouch dilatation - 1); 12 biliopancreatic diversions with duodenal switch (BPD-DS) after 29 (18-43) months due to pouch and/or esophageal motility disorders (9) or insufficient weight loss (3), in 6 patients after having already performed a re-banding for slippage. 9 revisions of the access-port were done after 6 (2-53) months (disconnection - 3, dislocation - 6). The morbidity of the re-operations was 5.3%: 1 hematoma in the abdominal wall and 1 temporary dysphagia after re-banding, 1 pulmonary embolism following BPD-DS. There have been no deaths. In patients with a minimal follow-up of 3 years (n = 92), the yearly re-operation rate was 11-12%. No slippage has occurred with the new 11-cm Lap-Band. CONCLUSION: Re-operations after LAGB for band-associated complications were frequent but could be performed safely with little morbidity. When the new 11-cm Lap-Band was employed, the high slippage rate dropped.
Authors: João de Bona Castelan; Jane Bettiol; Armando José d'Acampora; João Vicente Edom Castelan; Jonathan Caon de Souza; Vinicius Bressiani; Simone Batisti Giroldi Journal: Obes Surg Date: 2007-07 Impact factor: 4.129
Authors: F B Langer; A Bohdjalian; S Shakeri-Manesch; F X Felberbauer; B Ludvik; J Zacherl; G Prager Journal: Obes Surg Date: 2008-04-26 Impact factor: 4.129
Authors: Ruben Schouten; Dorothee C Wiryasaputra; Francois M H van Dielen; Wim G van Gemert; Jan Willem M Greve Journal: Obes Surg Date: 2010-12 Impact factor: 4.129