A Systematic Review of Banded vs. Non-Banded Sleeve Gastrectomy Regarding Long Term Results

Abstract

Abstract Background Laparoscopic Non-Banded Sleeve Gastrectomy (NBSG) is a widely popular weight loss procedure that has been around since the start of the millennium. Another variant, the Laparoscopic Banded Sleeve Gastrectomy (LBSG) started to emerge later. Questions have arisen on whether NBSG or BSG have better outcomes on the long run regarding weight loss, weight regain and reflux disease. This study aims to analyse previous studies performed on this subject and devise a conclusion regarding this matter. Obesity is a worldwide health issue with an unfortunate impact on an individual‘s quality of life. As of 2016, 39% of the world population suffered from obesity. Bariatric surgery is currently considered to be an effective and sustainable solution with increasing worldwide prevalence. Laparoscopic sleeve gastrectomy was first performed as the first step in biliopancreatic diversion with duodenal switch. Objective To scrutinize all English language papers written on the subject of comparing NBSG and LBSG as primary bariatric procedures and furthermore seeks to determine the superior surgery between them regarding weight loss, post-operative morbidity and complications like regurgitation, vomiting, reflux, dysphagia, and finally resolution of comorbidities like T2DM and HTN. Methodology This systematic review was carried out according to the updated PRISMA 2020 statement. A thorough search was executed in the Medline (PubMed) database, Elsevier‘s Scopus, Web of Science and the Cochrane Library in December 2022. Search was restricted to articles written in English. Search terms will be broad to encompass Banded Sleeve procedures. Results Our review revealed that the existing literature suggests increased weight loss following LBSG compared to NBSG; however, there‘s an increased risk of regular regurgitation episodes and of device related complications leading to revision surgeries (such as band removal). Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2023. Conclusion Laparoscopic banded sleeve gastrectomy provides apparent better outcomes than non- banded sleeve gastrectomy regarding sustainable weight loss results through 3-5 years of follow up as the studies we reviewed had demonstrated. Nonetheless, it poses a definite increase in the risk of regurgitation, vomiting and ring related complications that might require revision surgeries. More RCTs with longer follow up periods (>5 years) will significantly add to our understanding of the matter. Larger LBSG sample sizes are needed to further enhance our impression on efficacy and safety of the banded sleeve gastrectomy. Finally, larger T2DM and HTN patients‘ sample size is needed to form a conclusion on the relationship between banding and the resolution of these diseases.