• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Comparative Study of Laparoscopic Revision of Failed Gastric Banding to Sleeve Gastrectomy Versus Roux-En-Y Gastric Bypass

Rodrigo Gonzalez, MD, Edwin Bran, MD, Fernando Montufar, MD

Las Americas Private Hospital

BACKGROUND: Successful weight following bariatric surgery is defined as losing 50% of the excess body weight at long-term follow-up. All types of bariatric operations have a percentage of failure due to inadequate weight loss or weight regain. Revisional bariatric surgery is an alternative to induce further weight loss in these patients. However, it is still unclear which is the appropriate operation following failed gastric banding, either another restrictive procedure like the sleeve gastrectomy (SG) or a combined restrictive and malabsorptive procedure like the Roux-en-Y gastric bypass (RYGB). The aim of this study is to review outcomes between converting a failed gastric banding to SG versus RYGB.

METHODS: We reviewed prospectively collected data of 916 patients undergoing gastric banding since the year 2000. Data from patients undergoing revisional surgery for failed gastric banding due to inadequate weight loss or weight regain were included in this study. The decision of the type revisional surgery to perform was made by the patients after our multidisciplinary team explained them all the details of each operation. Demographics including age, gender, and weight were analyzed. Comparisons between operative results, complications, and postoperative weight loss were performed. Continuous data were evaluated using either Student’s t-test or Mann-U Whitney and ordinary data were evaluated using Fisher’s exact test. Results are reported as mean+/-SD or median (range), as appropriate. A p<0.05 was considered statistically significant.

RESULTS: Of the 42 (4.6%) patients undergoing revisional bariatric surgery for failed gastric banding, 22 (52%) underwent conversion to SG and 20 (48%) underwent conversion to RYGB. All patients underwent laparoscopic surgery. Weight at the time of the revisional surgery was 236+-26 and 257+/-45 lb in patients undergoing revision to SG and RYGB, respectively (p=NS). There was no difference in age (35 +/-11 vs 43+/-14 years), gender ratio (73% vs 60% male patients), estimated blood loss (163 [50-600] vs 180 [50-800] ml), rate of conversion to open surgery (9% vs 5%), intraoperative complications (9% vs 10%), postoperative complications (14% vs 20%) between patients undergoing conversion to SG and RYGB, respectively. However, there was a significant difference in operative time (155+/-26 vs 208+/-45 min), length of hospital stay (2+/0.5 vs 4+/2 days), and return to normal activities (7+/2 vs 11+/4 days) between patients undergoing conversion to SG and RYGB, respectively. Follow-up was similar between patients in the SG (58+/-28 months) and RYGB (51+/21 months) groups. Weight loss was 66+/-24 and 80+/-33 lb in patients undergoing conversion to SG and RYGB, respectively (p=NS).

CONCLUSIONS: Revisional bariatric surgery through laparoscopic approach in patients with inadequate weight loss following gastric banding is safe and effective. Both procedures result in significant weight loss at long-term follow-up with low complication rates. Results of conversion to both sleeve gastrectomy and Roux-en-Y gastric bypass are comparable. However, the more demanding technical aspects of converting a gastric band to RYGB results in increased operative times, length of hospital stay and length to return to normal activities. Further analysis to determine which is the best procedure should be addressed with a prospective randomized trial.


Session: Podium Presentation

Program Number: S014

209

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2013 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons