Banded Roux-en-Y gastric bypass for the treatment of morbid obesity.
BACKGROUND
Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the most effective treatment for morbid obesity. The additional benefit of placing a nonadjustable band around the pouch remains to be determined. The objective of this study was to compare outcomes between banded and nonbanded LRYGB patients in a single bariatric center.


METHODS
A matched cohort analysis was performed between patients who had undergone banded and nonbanded (standard) LRYGB. In the banded bypass cohort, an 8 F, 6.5 cm silastic ring was placed around the proximal gastric pouch. Both cohorts were matched for age, body mass index (BMI), and anastomotic technique. Endpoints included percentage excess weight loss (%EWL), postoperative morbidity, and band-related complications.


RESULTS
Between January 2007 and July 2010, 134 banded LRYGB were performed (55% female, mean age 45 years). They were compared with a matched cohort of 134 concurrent nonbanded LRYGB patients (67% female, mean age 45.4 years). Mean preoperative BMI was 54.6 and 52.8 kg/m(2), respectively (P = .084). At 24 months postoperatively, the average %EWL was 58.6% in banded bypass patients and 51.4% in the nonbanded group (P = .015). The difference in EWL was more pronounced in super-obese patients than in those with BMI<50 (among super-obese, 57.5% versus 47.6%, P = .003; among those with BMI<50, 62.9% versus 57.9%, P = .406]. There was no difference in early (19.4% versus 19.4%) or late complications (10.4% versus 13.4%, P = .451) between banded and nonbanded LRYGB patients.


CONCLUSIONS
Banding the pouch during LRYGB can be performed safely and may provide better weight loss, particularly in super-obese patients. Further prospective and long-term comparative studies of this technique are warranted.
Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: helenheneghan@hotmail.com.
Helen M
HM
Heneghan
Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
Shorat
S
Annaberdyev
Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
Shai
S
Eldar
Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
Tomasz
T
Rogula
Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
Stacy
S
Brethauer
Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
Philip
P
Schauer
D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
Banded gastric bypass; Bariatric surgery; Morbid obesity; Roux-en-Y gastric bypass (RYGB); Silicone ring; Weight loss