Mohamed Lasheen, Tamer Salama and Youhanna Shohdy Shafik
Background: Laparoscopic adjustable gastric band was one of the commonest bariatric surgery, but due to failure to maintain weight loss and incidence of complications more and more revisional surgeries are done nowadays, for patients with a previous gastric band. This study examined the outcome of one step revision from laparoscopic adjustable gastric band to laparoscopic single anastomosis gastric bypass.
Methods: Between 2015 and 2018 we had 38 cases at Ain Shams university hospitals, converted from LAGB to LSAGB. The cause of revision of the LAGB was mainly due to failure of weight loss, vomiting, abdominal pain, and reflux esophagitis. One year outcome of the procedure regarding, early and late complications, mortality, weight loss, and BMI changes were assessed.
Results: In this study, LASGB were performed as a revisional surgery after LAGB in 38 patients. The BMI was 44.2 kg/m2 ± 4.7 before surgery, which dropped after surgery to 38.6, 33.9, 31.5 after 3, 6, and 12 months respectively. No mortalities were recorded in this study. The mean operative time was 127.6 ± 17.4, min and the mean length of stay in hospital was 2.3 ± 1.2 days. Early complications were found in 7.89% formed of postoperative bleeding (2 patients) which was managed conservatively, and DVT (1 patient). Late complications occurred in 5.6% in the form of anastomotic ulcer (1 patient), managed medically and one case was converted to RYGB due to intractable biliary reflux.
Conclusion: Laparoscopic SAGB is a safe and effective revisional option for patients with failed LAGB, however, some cases may be technically challenging, also more studies with larger groups and longer follow up periods are needed.