title: Primary silicone-banded laparoscopic sleeve gastrectomy: a pilot study.
abstract: BACKGROUND
  Some degree of inadequate weight loss or recidivism is seen with all bariatric surgical approaches. To combat this, some authors have suggested placing a reinforcing ring around gastric bypass pouches or gastric sleeves. The aim of this study was to assess the initial feasibility and efficacy of silicone-banded laparoscopic sleeve gastrectomy (LSG).
  
  
  METHODS
  All cases of silicone-banded LSG performed at our center were retrospectively identified. Patient demographics, perioperative parameters, and postoperative outcomes were extracted and analyzed.
  
  
  RESULTS
  Thirteen patients (7 females, 6 males) were identified and analyzed. Preoperatively, patients had a mean age of 56.0 ± 8.3 years, a mean body mass index (BMI) of 53.7 ± 8.5 kg/m(2), and a median of seven comorbidities. All cases were completed laparoscopically by one surgeon, with a mean operative time of 140.7 ± 25.7 minutes and a mean estimated blood loss of 56.9 ± 30.6 mL. There were no mortalities. The only intraoperative complication was a respiratory arrest after extubation, and this patient recovered fully. Postoperatively, 2 patients (15.4%) experienced a complication: one had a pulmonary embolism requiring brief re-admission, and the other had a syncopal episode from a second-degree atrioventricular block. No long-term complications were encountered. One patient was lost to follow-up. At a median follow-up of 16 months (range, 6-27 months), the mean BMI of the cohort was 38.7 ± 7.9 kg/m(2), which corresponded to a mean excess weight loss (EWL) of 54.8 ± 19.6%.
  
  
  CONCLUSIONS
  This report provides initial evidence that silicone-banded LSG is feasible and can be performed with minimal morbidity and significant EWL at short-term follow-up.
authors: Bariatric and Metabolic Institute, Cleveland Clinic , Cleveland, Ohio.
authors: Christopher R
authors: CR
authors: Daigle
authors: Ricard
authors: R
authors: Corcelles
authors: Philip R
authors: PR
authors: Schauer
mesh_terms: D000368:Aged; D050110:Bariatric Surgery / Q000379:methods; D015992:Body Mass Index; D015897:Comorbidity; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D010865:Pilot Projects; D012189:Retrospective Studies; D012828:Silicones; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D012828:Silicones