title: Laparoscopic adjustable banded sleeve gastrectomy as a primary procedure for the super-super obese (body mass index > 60 kg/m2).
abstract: Isolated laparoscopic sleeve gastrectomy is increasingly being used for the treatment of morbid obesity. However, doubts still persist regarding long-term weight loss, and the 5-year results are awaited. Whether the aetiology of failed excess weight loss is the result of an inadequate sleeve or attributable to dilatation of the sleeve is not clear. In an effort to prevent gastric dilatation and increase gastric restriction to promote further weight loss in the long term, we performed a combined procedure of laparoscopic adjustable gastric banding with sleeve gastrectomy. The patient was a 39-year-old woman with a life-long history of obesity and a body mass index of 79.8 kg/m(2). The surgical technique of the laparoscopic adjustable gastric banded sleeve gastrectomy is described. There were no immediate complications, and the patient was discharged home on the third postoperative day. She is doing extremely well on clinic follow-up at 6 weeks. To the best of our knowledge, laparoscopic adjustable gastric banded sleeve gastrectomy, as a primary operation, has not been described in the literature. It is hoped that this combined procedure will be most useful in the super-super obese (body mass index > 60) patients. More patients with a long-term follow-up are necessary to provide definitive conclusions regarding long-term benefits and complications of this combined bariatric procedure.
authors.affiliation: Department of Bariatric Surgery, Homerton University Hospital, London, UK. sanju_agrawal@hotmail.com
authors.forename: Sanjay
authors.initials: S
authors.lastname: Agrawal
authors.forename: Els
authors.initials: E
authors.lastname: Van Dessel
authors.forename: Faki
authors.initials: F
authors.lastname: Akin
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Van Cauwenberge
authors.forename: Bruno
authors.initials: B
authors.lastname: Dillemans
mesh_terms: D000328:Adult; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D009767:Obesity, Morbid / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome
references.citation: Obes Surg. 2005 Sep;15(8):1124-8
references.pmid: 16197783
references.citation: Surg Obes Relat Dis. 2008 Mar-Apr;4(2):84-90
references.pmid: 17400032
references.citation: Obes Surg. 2004 May;14(5):677-82
references.pmid: 15186638
references.citation: Obes Surg. 2009 Nov;19(11):1591-6
references.pmid: 19727978
references.citation: Obes Surg. 2004 Jun-Jul;14(6):773-6
references.pmid: 15318980
references.citation: Obes Surg. 2005 Apr;15(4):517-22
references.pmid: 15946432
references.citation: Obes Surg. 2001 Oct;11(5):635-9
references.pmid: 11594110
references.citation: Surg Obes Relat Dis. 2006 Jul-Aug;2(4):464-7
references.pmid: 16925382
references.citation: Obes Surg. 2000 Dec;10(6):514-23; discussion 524
references.pmid: 11175958
references.citation: Obes Surg. 2003 Dec;13(6):861-4
references.pmid: 14738671
references.citation: Surg Endosc. 2009 Apr;23(4):884
references.pmid: 19118417
references.citation: Obes Surg. 2003 Jun;13(3):444-9
references.pmid: 12841909
references.citation: Obes Surg. 2006 Nov;16(11):1535-8
references.pmid: 17132421
references.citation: Obes Surg. 2006 Nov;16(11):1445-9
references.pmid: 17132409
references.citation: World J Surg. 1998 Sep;22(9):947-54
references.pmid: 9717420
references.citation: Obes Surg. 2008 May;18(5):560-5
references.pmid: 18317859
references.citation: Obes Surg. 1998 Jun;8(3):267-82
references.pmid: 9678194
references.citation: Obes Surg. 2006 Feb;16(2):166-71
references.pmid: 16469218