Feasibility of laparoscopic sleeve gastrectomy as a revision procedure for prior laparoscopic gastric banding.
BACKGROUND
Laparoscopic sleeve gastrectomy (LSG), initially described by Gagner's group as the first stage of the laparoscopic duodenal switch in super-obese patients, is now gaining wide diffusion among bariatric surgeons as a new restrictive operation.


METHODS
From January 2005 to January 2006, 8 obese patients with BMI 37-74 kg/m(2) underwent LSG for conversion from a prior complicated or failed laparoscopic adjustable gastric banding (LAGB). Three patients had severe symptomatic esophageal dilation, while 5 patients had unsuccessful weight loss with poor "band compliance". After de-banding, LSG was calibrated upon a 34-Fr gastric bougie, and blue and green linear staplers were used. The staple-line was buttressed by placing a sero-serosal running suture in all but one patient, and methylene blue dye was used to test for leaks. All the patients underwent upper GI series with water-soluble contrast medium 2 days after the surgery.


RESULTS
The average operating-time for LSG was 90 minutes (range 60-120 min). The average hospital stay was 4 days (range 3-7). There were no perioperative complications, no conversion, and no mortality. No intraoperative or postoperative blood transfusions were required.


CONCLUSIONS
LSG proved to be feasible and safe after LAGB. Longer follow-up and larger series are needed to assess weight loss results.
Bernante
Paolo
P
Istituto di Patologia Speciale Chirurgica, Università di Padova, Italy. paolo.bernante@unipd.it
Foletto
Mirto
M
Busetto
Luca
L
Pomerri
Fabio
F
Pesenti
Francesco Francini
FF
Pelizzo
Maria Rosa
MR
Nitti
Donato
D
D000328:Adult; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid; D012086:Reoperation; D017792:Surgical Stapling; D017211:Treatment Failure