Conversion of Laparoscopic Adjustable Gastric Banding to Gastric Bypass: a Comparison to Primary Gastric Bypass

Abstract

Albeit longer operating time, revision of LAGB to LRYGB is a safe procedure, with similar complication rates when compared to primary LRYGB. Although revisional LRYGB does result in less weight loss than primary LRYGB, the procedure's safety makes it a very plausible option as a rescue operation for failed LAGB.

One anastomosis gastric bypass vs. Roux-en-Y gastric bypass, remedy for insufficient weight loss and weight regain after failed restrictive bariatric surgery

“…However more recent studies report an incidence of internal herniation of 3.4-4.2% after revisional laparoscopic RYGB, for which intervention was needed, which is still higher than the incidence we found after revisional OAGB. [52,53] Thus, we conclude that OAGB as a revisional procedure is at least as safe as RYGB concerning the development of late complications for which intervention is needed. No differences in reduction in comorbidity after up to three years of follow up between OAGB and RYGB.…”

“…However more recent studies report an incidence of internal herniation of 3.4-4.2% after revisional laparoscopic RYGB, for which intervention was needed, which is still higher than the incidence we found after revisional OAGB. [ 52 , 53 ]…”

Revisional One Anastomosis Gastric Bypass with a 150-cm Biliopancreatic Limb After Failure of Adjustable Gastric Banding: Mid-Term Outcomes and Comparison Between One- and Two-Stage Approaches

“…Al-Kurd et al [42] compared RYGB after failed LAGB versus primary RYGB, including 161 patients in both groups. They showed no differences in short-term and long-term Grade 3a (n = 6) Grade 3b (n = 4) Grade 4 (n = 1) Pneumonia/atelectasis 5 (2.3) Grade 2 (n = 5) Small bowel perforation 1 (0.5) Grade 3b (n = 1) Anastomotic inflammation without abscess 1 (0.5) Grade 2 (n = 1) Phlebitis 1 (0.5) Grade 2 (n = 1) Myocardial infarction 1 (0.5) Grade 2 (n = 1) Pneumothorax 1 (0.5) Grade 3a (n = 1) GI bleeding without the need of transfusion 1 (0.5) Grade 1 (n = 1) Bleeding from the drain without the need of transfusion 4 (1.9) Grade 1 (n = 4) Anastomotic stenosis 2 (0.9) Grade 3a (n = 2) Total 29 (13.5) postoperative morbidity rates (7.5% in the revisional group versus 11.8% in the primary RYGB, non-significant) but better WL results for primary RYGB (61.5% vs. 75.5% of EWL, respectively, with 6-month follow-up attained in 78% of the patients).…”

“…Al-Kurd et al [ 42 ] compared RYGB after failed LAGB versus primary RYGB, including 161 patients in both groups. They showed no differences in short-term and long-term postoperative morbidity rates (7.5% in the revisional group versus 11.8% in the primary RYGB, non-significant) but better WL results for primary RYGB (61.5% vs. 75.5% of EWL, respectively, with 6-month follow-up attained in 78% of the patients).…”

Laparoscopic management of a left hepatic vein injury during one -step laparoscopic Roux-en-Y gastric bypass after adjustable gastric banding removal: A case report

“…Additional surgery after laparoscopic adjustable gastric banding (LAGB) failure seems to be a logic option, and laparoscopic Roux-en-Y gastric bypass (LRYGB) currently remains one of the rescue options with satisfactory results and acceptable morbidity [8] . It is called a revisional surgery, and performed in more than 20% of patients after laparoscopic gastric banding [9] .…”