Revisional surgery after removal of eroded adjustable gastric bands

Abstract

The aim of the study is to present surgical techniques and treatment outcomes for re-banding and sleeve gastrectomy as a revisional surgery after removing eroded adjustable gastric bands. A retrospective analysis was performed to study laparoscopic re-banding or sleeve gastrectomy as revisional surgery for band erosion. Main outcome measures were success of therapeutic strategies, morbidity, body mass index, and percentage total excess weight loss before and after revision. From March 2013 to June 2017, a total of 11 patients underwent the revisional surgery. Six patients underwent sleeve gastrectomy at median 15.7 months (13.2-73.3 months) after band removal, and 5 patients gastric re-banding at median 5.4 months (3.1-43.8 months). One of the six patients that underwent sleeve gastrectomy was diagnosed to have a minor leak. No other critical postoperative complication was observed in each group. Median BMI at revision in the sleeve gastrectomy group was 32.7kg/m2 (31.2-40.8kg/m2). Median follow-up after revision was 33.8 months (15.5-63.7 months), and at last follow-up, median BMI was 26.4kg/m2 (23.6-34.6kg/m2), and median %TWL was 17.6% (9.5-31.5%). In the rebanding group, median BMI at revision was 30.7kg/m2 (27.0-41.4kg/m2). Median follow-up after revision was 25.5 months (13.5-45.4 months), and at last follow-up, median BMI was 23.5kg/m2 (22.0-30.1kg/m2) and median %TWL was 23.9% (9.1-29.0%). Given the surgical techniques adopted, both re-banding and sleeve gastrectomy were found to be safe and effective revisional surgery after removal of eroded gastric band.