Miguel A Dorantes, MD1, Jorge E Perez Figueroa, MD2, Claudia C Dorantes, MD1, Gerardo Bautista, MD1. 1Centro Certificado en Cirugía Minimamente Invasiva para la Obesidad y Diabetes, Veracruz, México, 2Hospital Star Medica Veracruz
INTRODUCTION: Laparoscopic Gastric Band (LGB) is a restrictive and reversible method for the treatment of Morbid Obesity (MO), its positioning technique is simple and is one of the most popularly used. The dysfunction incidence and/or long term failure is high. At the moment, the removal of the band is the most used method, even though these resolve the complications, it is also associated with a fast recovery or persistence of the obesity.One Anastomosis Gastric Bypass (OAGB) is a restrictive/Malabsortive method, several authors have demonstrated good results.The aim of this intervention is to show our initial experience in 18 patients with persistent MO secondary to a dysfunctional LGB in whom laparoscopic removal of the GB and conversion to OAGB was performed at the same surgical time with a follow up to 1, 3 and 6 months.
METHODS AND PROCEDURES: From September of 2010 to April of 2014, 18 patients with persistent MO secondary to a dysfunctional LGB were operated on laparoscopically of retirement and conversion to OAGB in the same surgical time. Data Include: demographics, preoperative Body Mass Index (BMI), symptomatology and associated preoperative morbidity, surgical time, duration of hospital stay and postoperative weight loss t to 1, 3 and 6 months.
RESULTS: Age average was 35,7 years (19-50), BMI average: 42.0 kg/m2 (35,1 – 57,2). 10 (55,5%) referred progressive increase in the rations of food. Associate morbidity: Diabetes Mellitus 5 (27,7%), Hypertension: 4 (22,2%), sleep apnea: 6 (33,3%). The operating time was 161 (125-210) minutes. Removal of the band was made by dissection of the gastric plication, exposition and cut of the safety pin and extraction. The creation of the gastric pouch began at 7-8 cm below the GE junction with 32 Fr. calibration bougie and the G-J anastomosis was created at 250 cm from the Treitz fixation. In one patient (5,5%) cholecystectomy due to lithiasis was made. All cases were completed by laparoscopically. Water-soluble gastrography was done 48 hours after surgery. The hospital stay was 2,38 (1-4) days. 1 patient (1,1%) presented a non-complicated pneumonia that required re-hospitalization. 2 patients (11,1%) declared to have dyspeptic symptoms. Mortality was 0. The follow up was made every month during the first 6 months. The loss percentage of weight excess was: 3 months 36,4%, 6 months 55,6%.
CONCLUSION: The conversion to OAGB is effective for the treatment of the dysfunctional and/or insolvent LGB, with short term favorable results in weight loss.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80290
Program Number: P560
Presentation Session: Poster (Non CME)
Presentation Type: Poster