Shinban Liu, DO, Christine J Ren-Fielding, MD, Bradley Schwack, MD, Marina Kurian, MD, George A Fielding, MD. NYU Langone Medical Center
Introduction: Laparoscopic Roux-en-Y gastric bypass (RYGB) is a common and effective form of bariatric weight loss surgery. However, a subset of patients will fail to achieve the expected total body weight loss (TBWL) greater than 20% after 12 months or experience significant weight regain despite dietary, psychiatric, and behavioral counseling. Although alternative procedural interventions exist for operative revision after suboptimal RYGB weight loss, laparoscopic adjustable gastric banding (LAGB) provides an option with short operative time, low morbidity, and effective results. We have previously demonstrated that short-term (12-month), and mid-term (24-month) weight loss is achievable with LAGB for failed RYGB. The objective of this study is to report the long term 5 year outcomes of LAGB after RYGB failure.
Methods and Procedures: A retrospective review of prospectively collected data before and after RYGB when available, and before and after revision with LAGB was performed. The data included weight, height, body mass index, gender, race, age, operative time, length of stay, postoperative complications, and percentage of total body weight loss.
Results: A total of 182 patients (81.3% female, 18.7% male) were included in this study. The mean age of patients undergoing LAGB after RYGB was 47 ± 9.98 years old. The majority of patients (98.4%) underwent gastric band placement laparoscopically, with 2 patients requiring conversion to an open procedure, and 1 planned open approach.
The mean preoperative weight was 319 ± 64lbs and BMI of 53 ± 10 kg/m2 before RYGB. After RYGB, patients experienced a mean %TBWL of 16 ± 11%, had a weight of 264 ± 50lbs, and a BMI of 43 ± 7 kg/m2 before undergoing LAGB an average of 9 years after their first bariatric procedure. At the time of 5 year follow up after LAGB the patients had a %TBWL of 35 ± 13%, weight of 201.9 ± 46lbs, and had a BMI of 33 ± 7 kg/m2.
The mean operative time was 73 ± 34 minutes and 85% of patients had a hospital length of stay less than 24 hours.
Conclusion: The results of our study have shown that LABG had good long term data as a revisionary procedure for weight loss failure after RYGB. Patients experienced a satisfactory amount of total body weight loss with reduction in BMI and had a short operative time and length of stay.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86802
Program Number: P565
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster