Laparoscopic Adjustable Gastric Banding After Failed Roux-En-Y Gastric Bypass

Uittenbogaart, Martine; Leclercq, Wouter K G; Luijten, Arijan A. P. M.; Dielen, François Mh van

doi:10.1007/s11695-016-2283-0

Cited by 25 publications

(35 citation statements)

References 20 publications

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“…The nine re-operated patients achieved a weight loss of 12.0 kg (SD = 10.8), recalculated as 35.9% EWL (SD = 36.2) and 29% TWL (SD = 5.2) 24 months after surgery. This result differs from the weight loss that was found earlier in forty re-operated patients lacking an MDT approach (17.6% EWL, SD = 28.3) [9]. This difference suggests that weight loss outcomes of surgically treated non-responders have been improved due to the introduction of an MDT.…”

Section: Discussioncontrasting

confidence: 72%

“…The most interesting nding is that the minority of patients (13%) underwent revisional surgery, while all other patients (87%) were considered as not eligible for surgery. Before the introduction of an MDT evaluation in our center, the rate of revisional surgery was much higher (68% versus 13%) [9]. Based on these ndings, it is likely to assume that an MDT approach reduced the indication for revisional surgery.…”

Section: Discussionmentioning

confidence: 84%

“…Revisional BS constitutes a popular solution for non-responders. Commonly offered revisional procedures are Roux-en-Y gastric bypass (RYGB), lengthening of biliopancreatic limb, band placement, revision of the gastric pouch and/or stoma or biliopancreatic diversion/ duodenal switch (BPD/DS) [7][8][9]. Up to now, the e cacy and safety of these procedures remain controversial as each procedure brings along speci c risks [10].…”

Section: Introductionmentioning

confidence: 99%

“…Based on previous research in our center between 2012 and 2015, it has been identi ed that before the introduction of an MDT, 68% of the non-responders underwent revisional surgery [9]. This study included 65 patients with weight loss failure and weight regain who were consulted by a bariatric surgeon, though consultation by a dietician and physical therapist and/or medical psychologist was not scheduled routinely.…”

Section: Introductionmentioning

confidence: 99%

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Multidisciplinary approach of non-responders after bariatric surgery reduces the indication for revisional surgery: a retrospective cohort study

Romeijn

Dielen

Luijten

et al. 2020

Preprint

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Background 20–30% of patients show a lack of response after bariatric surgery (BS). These non-responders may experience insufficient weight loss or significant weight regain. Based on previous research in our center, it has been identified that before the introduction of a multidisciplinary team (MDT), 68% of the non-responders underwent revisional surgery. This study describes the effect of an MDT on treatment strategy in non-responders after BS. Methods this retrospective study included non-responders that were reviewed in an MDT meeting. Patients were categorized as primary non- responders (1NR) or as secondary non-responders (2NR). Outcomes assessed were: I. MDT-based treatment (conservative versus operative), II. Weight loss, III. Complications after revisional surgery. Results a total of 104 patients were included (n = 15 1NR, n = 89 2NR). In 73 patients, lifestyle and/or behavioral changes were indicated. Only eleven patients (13%) were re-operated in which one complication occurred. Twenty patients did not show up at their appointment with the dietician, physical therapist and/or medical psychologist and were excluded from further analysis. Conservatively treated patients lost 2.1 kg < 12 months (SD = 7.29) and 0.8 kg < 24 months (SD = 5.08). Surgically treated patients lost 12.0 kg < 12 months (SD = 4.29) and 26.3 kg < 24 months (SD = 2.75). Conclusions the rate of revisional surgery decreased after the introduction of an MDT. An explanation for this could be that an MDT drives more patients towards a conservative treatment since it identifies modifiable lifestyle and/or behavioral factors contributing to non-response. Incorporation of an MDT may contribute to the selection of patients who might benefit from revisional surgery.

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Section: Discussioncontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Multidisciplinary approach of non-responders after bariatric surgery reduces the indication for revisional surgery: a retrospective cohort study

Romeijn

Dielen

Luijten

et al. 2020

Preprint

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“…El BGYR está asociado con un fracaso entre el 15 y 35% 5 . La BGA laparoscópica en pacientes con BGYR previo es una técnica segura, que ha demostrado resultados efectivos en el porcentaje de pérdida de exceso de peso (PEP) en series pequeñas de pacientes, hasta un 38% PEP con seguimiento a 1 año 5 .…”

Section: Discussionunclassified

Experiencia inicial con cirugía revisional bariátrica asistida por robot

et al. 2018

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Initial experience with robotic assisted revisional bariatric surgery Background: Robotics in bariatric surgery is a novel development in medical institutions in Chile. Revisional bariatric procedures have increased during the last years. There are no publications in our country related to the initial experience and results in robotic revisional bariatric surgery. The aim of this study is to describe the initial experience and short term outcomes with robotic revisional bariatric surgery. Study Design: We conducted a retrospective study of all consecutive robotic revisional bariatric surgeries performed by a single surgeon in Clínica Santa María in Santiago, Chile. We analyzed demographic characteristics and surgical outcomes, morbidity, mortality and length of hospital stay. Results: 59 revisional bariatric surgeries were performed, 11 reshaping of sleeve gastrectomy, 34 Roux in Y gastric bypass, 1 pouch reshaping of Roux in Y gastric bypass, 3 extractions of laparoscopic adjustable gastric banding, 1 of them with simultaneous sleeve gastrectomy, 5 laparoscopic adjustable gastric banding to patients with previous Roux in Y gastric bypass, 3 total gastrectomy, 1 resection of gastro-gastric fistula and 1 gastro enteral anastomosis. Mean age was 47.8 years. Average preoperative body mass index was 33.86 kg/m 2. Mean surgical time was 101.63 minutes. Postoperative complications were observed in 3 patients (5.08%). In 2 (3.39%) of this patient, reoperation was required. There were no deaths in this group. Average length of hospital stay was 3.6 days. Conclusion: Robotic revisional bariatric surgery is a novel technique that appears to be safe and effective.

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Benefits of weight loss of 10% or more in patients with overweight or obesity: A review

Tahrani

Morton

2022

Obesity

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Obesity is a multifactorial chronic disease that is associated with increased risks of type 2 diabetes (T2D), cardiovascular disease, certain cancers, sleep apnea, subfertility, and mortality, among other complications (1). For adults, the World Health Organization (WHO) defines "overweight" and "obesity" as having BMI of 25 kg/m 2 or more and 30 kg/m 2 or more, respectively (2). According to WHO estimates, almost four in ten adults (39%) were overweight and more than one in ten (13%) had obesity in 2016 globally (2). As BMI does not reflect fat distribution, waist circumference provides further information about patient risks of T2D, hypertension, and cardiovascular disease, which increase with increasing BMI and waist circumference category (Table 1) (1). Risks of comorbidities and cutoff points for considering therapeutic intervention differ in Asian versus non-Asian populations, with BMI of 23 to 27.5 kg/m 2 conferring increased risk and BMI of 27.5 kg/m 2 or more conferring high risk in Asian individuals (3). Members of Black and some minority ethnic groups are also at increased risk of chronic health conditions at a lower BMI than the White population (BMI < 25 kg/m 2 ) (4).The global prevalence of obesity almost tripled between 1975 and 2016 (2), and it is increasingly becoming a public health priority.Overweight and obesity are responsible for a substantial disease burden and are associated with considerable direct costs (e.g., health care expenditure) and indirect costs (e.g., loss of productivity and gross domestic product [GDP]) (5,6). In 2014, 5% of deaths worldwide were attributable to obesity (7). Health expenditure associated with overweight/obesity is estimated to account for 2% to 8% of total health expenditure, although these values may be underestimates (5).Overweight and obesity and their consequences also negatively affect

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Laparoscopic Adjustable Gastric Banding After Failed Roux-En-Y Gastric Bypass

Cited by 25 publications

References 20 publications

Multidisciplinary approach of non-responders after bariatric surgery reduces the indication for revisional surgery: a retrospective cohort study

Multidisciplinary approach of non-responders after bariatric surgery reduces the indication for revisional surgery: a retrospective cohort study

Experiencia inicial con cirugía revisional bariátrica asistida por robot

Benefits of weight loss of 10% or more in patients with overweight or obesity: A review

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