title: Laparoscopic sleeve gastrectomy as revisional procedure for failed gastric banding and vertical banded gastroplasty.
abstract: BACKGROUND
  The problem of revision of failed gastric banding (GB) and vertical banded gastroplasty (VBG) procedures has become a common situation in bariatric surgery. Laparoscopic sleeve gastrectomy (LSG) has been recently used to revise failed restrictive procedures. The objective of this study is to evaluate the results of LSG as revisional procedure for failed GB and VBG.
  
  
  METHODS
  A prospective held database was questioned regarding patients' demographic, indication for revision, conversion to open surgery, morbidity, percentage of excess weight loss (%EWL), evolution of comorbidities, and need for a second procedure after LSG.
  
  
  RESULTS
  Forty-one patients, 34 women and seven men with a mean age of 42 years (range 19 to 63 years) and a mean body mass index at 49.9 kg/m(2) (range 35.9-63 kg/m(2)), underwent laparoscopic conversion of GB (36 patients) and VBG (five patients) into LSG. Indication for revisional surgery was insufficient weight loss in all the cases. All procedures were completed laparoscopically. There was no mortality and five patients (12.2%) developed complications (high leak, one patient; intra-abdominal abscess, three patients; and complicated incisional hernia, one patient). At a mean follow-up of 13.4 months, %EWL is on average 42.7% (range 4-76.1%). Six patients had a second procedure (four had laparoscopic duodenal switch, one had laparoscopic Roux-en-Y gastric bypass, and one had laparoscopic biliopancreatic diversion).
  
  
  CONCLUSIONS
  Conversion of GB and VBG into LSG is feasible and safe. LSG is effective in the short term with a mean %EWL of 42.7% at 13.4 months. Long-term results of LSG as revisional procedure are awaited to establish its efficacy in the long term.
authors: Service de Chirurgie Digestive et Transplantation Hépatique, Hôpital Archet 2, 151 Route Saint Antoine de Ginestiere, BP 3079, 06202 Nice, France. antonio_iannelli@hotmail.com
authors: Antonio
authors: A
authors: Iannelli
authors: Anne Sophie
authors: AS
authors: Schneck
authors: Emila
authors: E
authors: Ragot
authors: Arnaud
authors: A
authors: Liagre
authors: Yves
authors: Y
authors: Anduze
authors: Simon
authors: S
authors: Msika
authors: Jean
authors: J
authors: Gugenheim
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy; D015391:Gastroplasty; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D012086:Reoperation; D013997:Time Factors; D017211:Treatment Failure; D015431:Weight Loss; D055815:Young Adult