title: Intragastric stimulation is ineffective after failed adjustable gastric banding.
abstract: BACKGROUND
  Gastric pacing has gained popularity as an effective and safe minimally invasive procedure to treat morbid obesity. This study evaluates the outcome of gastric pacing as a bariatric re-do procedure in patients who developed failure after adjustable gastric banding (AGB) due to band migration.
  
  
  METHODS
  8 patients were enrolled in this analysis. After implantation of an AGB, they had developed band failure due to band migration. The implantable gastric stimulator (IGS) was implanted laparoscopically as a second-line operation after gastroscopic removal of the band.
  
  
  RESULTS
  Median time (range) from AGB complication to implantation of the IGS was 42 (10.3-50.3) months. During that time, all 8 patients had regained significant weight. All IGS devices could be implanted laparoscopically, without intra- or perioperative complications. The minimal body weight following IGS implantation was reached after 5 (0-12) months. The median observation time was 23 (11.3-27.5) months. 1 year after IGS implantation (n=7), median weight was 116 (98-165) kg, equivalent to a median BMI of 41.1 (36.055.8) kg/m(2), which is not statistically different to preoperative values and therefore prompted us to stop our ongoing trial. In all but 2 patients, the IGS device was explanted. During the same procedure, patients underwent a gastric sleeve resection (n=4) or a Roux-en-Y gastric bypass (n=2).
  
  
  CONCLUSIONS
  The implantation of an IGS was an ineffective second-line operation after AGB migration.
authors.affiliation: Medical University Innsbruck, Department of General and Transplant Surgery, Innsbruck, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Hoeller
authors.forename: Franz
authors.initials: F
authors.lastname: Aigner
authors.forename: Raimund
authors.initials: R
authors.lastname: Margreiter
authors.forename: Helmut
authors.initials: H
authors.lastname: Weiss
mesh_terms: D034861:Abdominal Wall; D000328:Adult; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000628:therapy*; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss