Abel Boerboom1, Edo Aarts2, Volker Lange3, Andreas Plamper4, Karl Rheinwalt4, Katja Linke5, Ralph Peterli5, Frits Berends2, Eric Hazebroek2. 1. Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands. aboerboom2@rijnstate.nl. 2. Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands. 3. Department of Obesity and Metabolic surgery, Helios Klinikum, Berlin, Germany. 4. Department of Bariatric, Metabolic and Plastic Surgery, St. Franziskus-Hospital, Cologne, Germany. 5. Department of Surgery, Clarunis Centre for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital, Basel, Switzerland.
Abstract
BACKGROUND: After laparoscopic Roux-en-Y gastric bypass (RYGB), approximately 10-35% of patients with morbid obesity regain weight after an initial good result or fail to achieve a sufficient amount of weight loss. Patients in which conservative measures are not successful may potentially benefit from revisional surgery. OBJECTIVE: To evaluate the effect of a non-adjustable ring placed around the gastric pouch in patients with insufficient weight loss or weight regain after RYGB. SETTING: Four specialized bariatric hospitals in The Netherlands, Germany, and Switzerland. METHODS: From 2011 to 2017, 79 patients underwent revisional surgery using a non-adjustable silicone ring because of insufficient results after RYGB. Data on weight loss and complications up to 2 years after revisional surgery was collected and analyzed retrospectively. RESULTS: A follow-up percentage of 86% after 1 year and 61% after 2 years was achieved. In 75% of patients, further weight regain was prevented. Percentage total body weight loss improved by 7 to 26% 1 year after revisional surgery and remained stable during 2 years of follow-up. The additional weight loss effect of placing a non-adjustable ring was more pronounced in patients with an initial good result after primary RYGB. Eighteen (23%) rings were removed, most often due to dysphagia. CONCLUSION: Especially for patients who experience weight regain after initial good weight loss, placing a non-adjustable silicone ring around the gastric pouch results in modest improvements in weight loss. To prevent the risk of ring removal due to dysphagia, surgeons should take notice not to place the ring too tight around the gastric pouch during revisional surgery.
BACKGROUND: After laparoscopic Roux-en-Y gastric bypass (RYGB), approximately 10-35% of patients with morbid obesity regain weight after an initial good result or fail to achieve a sufficient amount of weight loss. Patients in which conservative measures are not successful may potentially benefit from revisional surgery. OBJECTIVE: To evaluate the effect of a non-adjustable ring placed around the gastric pouch in patients with insufficient weight loss or weight regain after RYGB. SETTING: Four specialized bariatric hospitals in The Netherlands, Germany, and Switzerland. METHODS: From 2011 to 2017, 79 patients underwent revisional surgery using a non-adjustable silicone ring because of insufficient results after RYGB. Data on weight loss and complications up to 2 years after revisional surgery was collected and analyzed retrospectively. RESULTS: A follow-up percentage of 86% after 1 year and 61% after 2 years was achieved. In 75% of patients, further weight regain was prevented. Percentage total body weight loss improved by 7 to 26% 1 year after revisional surgery and remained stable during 2 years of follow-up. The additional weight loss effect of placing a non-adjustable ring was more pronounced in patients with an initial good result after primary RYGB. Eighteen (23%) rings were removed, most often due to dysphagia. CONCLUSION: Especially for patients who experience weight regain after initial good weight loss, placing a non-adjustable silicone ring around the gastric pouch results in modest improvements in weight loss. To prevent the risk of ring removal due to dysphagia, surgeons should take notice not to place the ring too tight around the gastric pouch during revisional surgery.
Authors: G Craig Wood; Peter N Benotti; Clare J Lee; Tooraj Mirshahi; Christopher D Still; Glenn S Gerhard; Michelle R Lent Journal: JAMA Surg Date: 2016-11-01 Impact factor: 14.766
Authors: Amir H Sohail; Raelina S Howell; Barbara M Brathwaite; Jeffrey Silverstein; Leo Amodu; Patricia Cherasard; Patrizio Petrone; Anirudha Goparaju; Jun Levine; Venkata Kella; Collin E M Brathwaite Journal: JSLS Date: 2022 Apr-Jun Impact factor: 1.789