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Cirugia revisional

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  • 1. Sleeve Gastrectomy as a RevisionalProcedure for Failed Gastric Banding Berry M, Urrutia L, Lamoza P, Rossi R Bariatric and Metabolic Surgical Unit Clínica Las Condes Santiago, Chile
  • 2. Introduction• Laparoscopic sleeve gastrectomy (LSG) has been recognized as a good treatment option for obesity and its comorbidities.• Revision of a failed laparoscopic adjustable gastric banding (LAGB) has become a common situation in bariatric surgery and the best procedure to be offered is still under debate.
  • 3. Introduction• Main indications for revisional surgery after LAGB: – Inadequate weight loss – Band Problems • Slippage • Malfunction of the tube-reservoir • Esophageal Dilatation • Pouch Dilatation – Poor quality of life• It is well known than succesful LAGB patients who require band removal gain weight thereafter.• In most cases, a new procedure is required to fulfill our objective: weight loss maintenance.
  • 4. Objective• To evaluate our results of a one-stage procedure, with conversion of a LAGB to a LSG as a revisional procedure for inadequate weight loss and/or complications after LAGB.• We analyze patient characteristics, operative time, hospital stay, % EBMIL, and morbimortality.
  • 5. ResultsN: 44 27 Fem 17 MaleAge years (20-62), were operated. 43.6 (20-62)BMI 35 (28 - 44)Years between LAGB to 3.5 ± 0.6LSG
  • 6. Results• Mean Op. Time: 96 min. (90-180)• Conversions: 0• Morbidity: 3 patients (6.8%) Treatment • Dysphagia: 1 Endoscopy • Persistent fever: 1 Laparoscopy: (-)REOP • Perigastric haematoma: 1 Non-operative• Mortality: 0%• Median Hospital Stay: 3 days
  • 7. Results BMI and % EBMIL Preop Postop 35 ± 3.7 29.6 ± 2.2 BMI (Kg/m2) (28-44) (22-39) % EBMIL 76.9 ± 12.1Mean follow-up: 16 months (6-34)
  • 8. Conclusions• LSG as a revisional surgery for a failed LAGB can be performed safely as a one stage procedure by experienced bariatric surgeons, and is effective as a weight loss procedure• Further follow-up of revisional LSG is necessary to establish its long-term efficacy.
  • 9. Thank you for your attention

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