Laparoscopic gastric bypass as a revision procedure after transoral gastroplasty.
BACKGROUND
Transoral gastroplasty (TOGA) has been offered as an investigational alternative restrictive procedure in our hospital for the last 3 years. Since laparoscopic Roux-en-Y gastric bypass (LRYGBP) can be performed as a revisional surgery after failure of a restrictive surgery, this study reports on the feasibility of conversion of TOGA into a LRYGBP in case of failure of the endoscopic procedure.


METHODS
Since 2006, 71 TOGA procedures were performed in morbidly obese patients. Four patients underwent an LRYGBP after TOGA procedure for unsatisfactory results after 1-year observation. All of them had undergone a second procedure in which additional TOGA restrictions were placed to attempt to tighten the pouch before being referred for LRYGBP. The surgical outcome of these patients was analysed.


RESULTS
All four patients were easily converted to a LRYGBP with no major complication and no mortality. The operative results (operating time, morbidities, follow-up) of all LRYGBP post TOGA were similar to primary LRYGBP performed by the same operator.


CONCLUSIONS
LRYGBP post-TOGA apparently can be done without any trouble. The performance of TOGA does not seem to interfere with the short-term results of the LRYGBP.
Closset
Jean
J
Medicosurgical Department of Gastroenterology, Erasmus Hospital, Free University of Brussels, Route de Lennik 808, 1070 Brussels, Belgium. jean.closset@erasme.ulb.ac.be
Germanova
Desy
D
Loi
Patrizia
P
Mehdi
Abdellah
A
Moreno
Christophe
C
Devière
Jacques
J
D005240:Feasibility Studies; D005260:Female; D015390:Gastric Bypass; D015391:Gastroplasty; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012086:Reoperation; D017211:Treatment Failure; D016896:Treatment Outcome