Vertical Banded Gastroplasty--Gastric Bypass: preliminary report

Capella, Rafael F.; Capella, Joseph F.; Mandac, Hernani; Nath, Prem

doi:10.1381/096089291765560782

Cited by 117 publications

(40 citation statements)

References 14 publications

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“…However, this resulted in a high incidence of band erosion and this procedure was abandoned. Fobi [22] reintroduced the ring and placed a silastic ring on a vertical pouch 2 cm above the gastroenterostomy rather than around the gastroenterostomy anastomosis [22, 23]. Ever since, several prosthetic devices have come to market, mostly silastic rings which are (laparoscopically) adjustable (MiniMizer®) or non-adjustable (GaBP Ring™) and may be placed around the pouch, proximal to the anastomosis.…”

Section: Discussionmentioning

confidence: 99%

Banded Gastric Bypass: Better Long-Term Results? A Cohort Study with Minimum 5-Year Follow-Up

Lemmens

2016

OBES SURG

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BackgroundWhile gastric bypass has been the treatment of choice for morbid obesity, insufficient weight loss and even weight regain has been observed in a sub-group of patients. Dilatation of the pouch, pouch outlet, and proximal alimentary limb have been suggested to cause weight regain on the long term. The banded gastric bypass surgery has been introduced to overcome this problem.MethodsFour hundred thirty-two patients (n = 254, non-banded/n = 178, banded-GaBP Ring™) were followed-up for 5 years. Patients were evaluated for weight loss, % excess weight loss (%EWL), weight regain and BMI.ResultsNo significant differences between groups in the first year following surgery were observed in terms of weight loss and %EWL. %EWL at 5 years was as follows: non-banded 65.2 ± 20.0 %; banded 74.0 ± 15.1 %. At 5 years, the banded group showed more weight loss (non-banded 35.4 ± 12.5; banded 43.9 ± 11.9 kg, P < 0.0001); weight regain was significantly higher in the non-banded group (P < 0.0001). Only minor complications were reported; no signs of ring migration or slippage were reported.ConclusionAlthough, following the first year after surgery, no differences in treatment groups were observed in terms of weight loss, 5 years following surgery, patients who received banded surgery maintained better weight loss and had less weight regain compared to the non-banded group. These results suggest that laparoscopic banded gastric bypass using a silastic ring was effective in maintaining weight loss on the long term, while the complication rate was low. The banded gastric bypass is regarded by us as the new gold standard.

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Section: Discussionmentioning

confidence: 99%

Banded Gastric Bypass: Better Long-Term Results? A Cohort Study with Minimum 5-Year Follow-Up

Lemmens

2016

OBES SURG

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“…It is characterized by the creation of a 40-ml gastric pouch, along with a Roux-en-Y bypass with functional exclusion of gastric remnant, duodenum and proximal jejunum, with a 100 cm excluded biliopancreatic limb and a Roux limb with about 150 cm; common channel comprehends the remaining intestine 7 , 15 It is associated with significant resolution rates of obesity-related comorbidities and long-term maintenance of excess weight loss 5 .…”

Section: Resultsmentioning

confidence: 99%

GLP-2: A Poorly Understood Mediator Enrolled in Various Bariatric/Metabolic Surgery-Related Pathophysiologic Mechanisms

Cazzo¹,

Gestic²,

Chaim³

et al. 2016

ABCD, arq. bras. cir. dig.

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Introduction: Glucagon-like peptide-2 (GLP-2) is a gastrointestinal hormone whose effects are predominantly trophic on the intestinal mucosa. Aim: Critically evaluate the current literature on the influence of bariatric/metabolic surgery on the levels of GLP-2 and its potential clinical implications. Methods: Narrative review through online research on the databases Medline and Lilacs. There were six prospective human studies, two cross-sectional human studies, and three experimental animal studies selected. Results: There is evidence demonstrating significant increase in the levels of GLP-2 following gastric bypass, Scopinaro operation, and sleeve gastrectomy. There are no differences between gastric bypass and sleeve gastrectomy in regards to the increase in the GLP-2 levels. There is no correlation between the postoperative levels of GLP-2 and the occurrence of adequate or insufficient postoperative weight loss. Conclusion: GLP-2 plays significant roles on the regulation of nutrient absorption, permeability of gut mucosa, control of bone resorption, and regulation of satiety. The overall impact of these effects potentially exerts a significant adaptive or compensatory effect within the context of varied bariatric surgical techniques.

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“…Initial devices commonly employed in vertical banded gastroplasties (VBG) included a fixed diameter silastic ring or even mesh prostheses. In 1991 the group of Capella was the first to describe the vertical banded gastroplasty-gastric bypass with a 5.5 cm supporting band around a small gastric pouch [23]. In that same year, Fobi et al published their results with the silastic ring vertical banded gastric bypass [24].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic adjustable banded roux-en-y gastric bypass as a primary procedure for the super-super-obese (body mass index > 60 kg/m2)

et al. 2010

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BackgroundCurrently, there is no consensus opinion regarding the optimal procedure of choice in super-super-morbid obesity (Body mass index, BMI > 60 kg/m2). Roux-en-Y gastric bypass (RYGB) is associated with failure to achieve or maintain 50% excess weight loss (EWL) or BMI < 35 in approximately 15% of patients. Also, percent EWL is significantly less after 1-year in the super-super-obese group as compared with the less obese group and many patients are still technically considered to be obese (lowest post-surgical BMI > 35) following RYGB surgery in this group. The addition of adjustable gastric band (AGB) to RYGB has been reported as a revisional procedure but this combined bariatric procedure has not been explored as a primary operation.MethodsIn a primary laparoscopic RYGB, an AGB is drawn around the gastric pouch through a small opening between the blood vessels on the lesser curve and the gastric pouch. The band is then fixed by suturing the gastric remnant to the gastric pouch both above and below the band to prevent slippage.ResultsBetween November 2009 and March 2010, 6 consecutive super-super-obese patients underwent a primary laparoscopic adjustable banded Roux-en-Y gastric bypass procedure at our institution. One male patient (21 years, BMI 70 kg/m²) developed a pneumonia postoperatively. No other postoperative complications were observed.ConclusionTo the best of our knowledge, this is the first series of patients that underwent a laparoscopic adjustable banded RYGB as a primary operation for the super-super obese in the indexed literature. With the combined procedure, a sequential action mechanism for weight loss is to be expected. The restrictive, malabsorptive and hormonal working mechanism of the RYGB will induce weight loss from the start reaching a stabilised plateau of weight after 12 - 18 months. At that time, filling of the band can be started resulting in further gastric pouch restriction and increased weight loss. Moreover, besides improving the results of total weight loss, a gradual filling of the band can as well prevent the RYGB patient from weight regain if restriction would fade away with time.

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Vertical Banded Gastroplasty--Gastric Bypass: preliminary report

Cited by 117 publications

References 14 publications

Banded Gastric Bypass: Better Long-Term Results? A Cohort Study with Minimum 5-Year Follow-Up

Banded Gastric Bypass: Better Long-Term Results? A Cohort Study with Minimum 5-Year Follow-Up

GLP-2: A Poorly Understood Mediator Enrolled in Various Bariatric/Metabolic Surgery-Related Pathophysiologic Mechanisms

Laparoscopic adjustable banded roux-en-y gastric bypass as a primary procedure for the super-super-obese (body mass index > 60 kg/m2)

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