Feasibility of laparoscopic sleeve gastrectomy as a revision procedure for prior laparoscopic gastric banding.

Author: Bernante P, Foletto M, Busetto L, Pomerri F, Pesenti FF, Pelizzo MR, Nitti D

Author affiliation: Istituto di Patologia Speciale Chirurgica, Universita di Padova, Italy. paolo.bernante@unipd.it

Publication date & source: 2006.10, Obes Surg., 16(10):1327-30.

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG), initially described by Gagner's group as the first stage of the laparoscopic duodenal switch in super-obese patients, is now gaining wide diffusion among bariatric surgeons as a new restrictive operation. METHODS: From January 2005 to January 2006, 8 obese patients with BMI 37-74 kg/m(2) underwent LSG for conversion from a prior complicated or failed laparoscopic adjustable gastric banding (LAGB). Three patients had severe symptomatic esophageal dilation, while 5 patients had unsuccessful weight loss with poor "band compliance". After de-banding, LSG was calibrated upon a 34-Fr gastric bougie, and blue and green linear staplers were used. The staple-line was buttressed by placing a sero-serosal running suture in all but one patient, and methylene blue dye was used to test for leaks. All the patients underwent upper GI series with water-soluble contrast medium 2 days after the surgery. RESULTS: The average operating-time for LSG was 90 minutes (range 60-120 min). The average hospital stay was 4 days (range 3-7). There were no perioperative complications, no conversion, and no mortality. No intraoperative or postoperative blood transfusions were required. CONCLUSIONS: LSG proved to be feasible and safe after LAGB. Longer follow-up and larger series are needed to assess weight loss results.