title: Laparoscopic adjustable gastric band revisional surgery: a single surgeon series.
abstract: BACKGROUND
  Laparoscopic adjustable gastric banding (LAGB) is a safe and proven surgical option for morbid obesity; however, the need for revisional surgery is being increasingly reported. This study reports outcomes and incidence for a large cohort of patients requiring revisional LAGB surgery for various indications.
  
  
  METHODS
  A retrospective review of prospectively collected data for 1524 primary LAGB placed between 2003 and 2013 by a single surgeon at a single institution was performed, analysing data for all patients in this cohort requiring revisional LAGB surgery.
  
  
  RESULTS
  A total of 434 revisions were performed on 349 patients. A total of 278 patients had a single revision, with 71 patients having two or more revisions. Revisions amounting to 213 were band repositions, 68 were band removal only and 153 were band removal with conversion to another bariatric procedure, mostly Roux-en-Y gastric bypass (n = 143). A total of 47 (35.1%) 'band-to-band' revision patients were lost to follow-up. Patients undergoing 'band-to-band' revision for a slipped band, patient intolerance and mechanical band failure had mean excess weight loss (EWL) at 4 years of 49.9% (n = 35), 38.6% (n = 10) and 67.4% (n = 6), respectively. Port or tubing revisions were not included. Mean follow-up for 'band-to-band' revision patients was 33.4 months (standard deviation 26.4 months). 22.9% of patients required one or more band revision procedures by 2013, increased from 13% in 2008.
  
  
  CONCLUSIONS
  Continued EWL is achieved with repositioning or replacement of a LAGB. However, a significant and increasing rate of re-operation over time exists.
authors.affiliation: Department of General Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors.forename: Joel
authors.identifier: http://orcid.org/0000-0002-5782-2262
authors.initials: J
authors.lastname: Lewin
authors.affiliation: Department of General Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors.forename: Beth
authors.initials: B
authors.lastname: Campbell
authors.affiliation: Department of General Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.|Department of Upper Gastrointestinal and Bariatric Surgery, Tan Tock Seng Hospital, Singapore.
authors.forename: Kaushal A
authors.initials: KA
authors.lastname: Sanghvi
authors.affiliation: Obesity Surgery Brisbane, Holy Spirit Northside Hospital, Brisbane, Queensland, Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Skinner
authors.affiliation: Department of General Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.|Obesity Surgery Brisbane, Holy Spirit Northside Hospital, Brisbane, Queensland, Australia.
authors.forename: George
authors.initials: G
authors.lastname: Hopkins
mesh_terms: D001315:Australia / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D011446:Prospective Studies; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: LAGB; band revision; bariatric surgery; gastric band; laparoscopic adjustable gastric band; revision surgery