title: Salvage banding for failed Roux-en-Y gastric bypass.
abstract: BACKGROUND
  After Roux-en-Y gastric bypass (RYGB), a substantial number of patients do not achieve successful long-term weight loss. In cases of loss of restriction, the application of an adjustable gastric band ("salvage banding") over the gastric pouch, or gastrojejunostomy, could prevent weight regain or increase weight loss. The objective of this literature review is to provide an overview of the studies that report the effect of salvage banding after failed RYGB.
  
  
  METHODS
  A systemic literature search was conducted in PubMed, Google Scholar, Medline, the Cochrane Library, and the online websites of specific bariatric surgery journals to identify all relevant studies describing salvage banding after failed RYGB.
  
  
  RESULTS
  Seven studies, with a total of 94 patients, were included for a systemic literature review. Inclusion criteria for salvage banding varied from unsuccessful weight loss to technical pouch failure. After salvage banding, all studies reported further weight loss, varying from 55.9%-94.2% excess body mass index loss (EBMIL) after 12-42 months of follow-up. In the included study group, 18% (17/94) of the patients developed long-term complications requiring a re-revision in 17% (16/94) of the cases.
  
  
  CONCLUSIONS
  The results of all 9 studies that were included in this review report a further increase in weight loss after salvage banding for failed RYGB. In case of insufficient weight loss or technical pouch failure after RYGB, all reports suggest that salvage banding is a safe and feasible revisional procedure. Prospective studies are necessary to determine to the success of direct application of an adjustable gastric band in primary RYGB.
authors.affiliation: Department of General Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands. guy.vijgen@gmail.com
authors.forename: Guy H E J
authors.initials: GH
authors.lastname: Vijgen
authors.forename: Ruben
authors.initials: R
authors.lastname: Schouten
authors.forename: Nicole D
authors.initials: ND
authors.lastname: Bouvy
authors.forename: Jan Willem M
authors.initials: JW
authors.lastname: Greve
mesh_terms: D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D009767:Obesity, Morbid / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D016879:Salvage Therapy / Q000379:methods*; D017211:Treatment Failure; D015431:Weight Loss