title: Banding the Sleeve Improves Weight Loss in Midterm Follow-up.
abstract: Laparoscopic sleeve gastrectomy (LSG) can achieve excellent weight loss, yet sleeve dilatation with concomitant weight regain proves to be a relevant issue. Hence, additional restriction might improve results after LSG.
  
  
  
  In a retrospective matched-pair analysis, 42 patients who underwent banded LSG (BLSG) using a MiniMizer® ring between January 2012 and October 2014 were analysed regarding weight loss, complications and comorbidity. Median follow-up was 3 years. Forty-two patients who had undergone conventional LSG were selected as matched pairs.
  
  
  
  Mean preoperative BMI was 54.93 ± 7.42 kg/m2for BLSG and 53.46 ± 6.69 kg/m2for LSG (Mann-Whitney P = 0.540). Total weight loss (%TWL) was significantly greater in the BLSG group 3 years after surgery (BLSG 38.22% ± 7.26; n = 26 vs. LSG 32.69 ± 9.47; n = 26; P = 0.0154). Ring placement had no relevant impact on new-onset reflux (Fisher's exact test P = 1.0) but a tendency towards reflux improvement when reflux pre-existed (odds ratio 1.96). The major side effect of ring implantation was regurgitation with over 44% of patients presenting with regurgitation >1 per week (Fisher's exact test P = 0.0019, odds ratio 18.07).
  
  
  
  BLSG is a safe procedure showing similar comorbidity to conventional LSG. However, BLSG leads to a higher rate of postoperative regurgitation. Weight loss is significantly improved 3 years after surgery. Hence, additional ring implantation might be an option for increased restriction in LSG surgery.
authors.affiliation: Department of General, Visceral and Transplant Surgery, Centre for Metabolic Surgery, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany. jodok.fink@uniklinik-freiburg.de.
authors.forename: Jodok M
authors.identifier: 0000-0002-6650-3490
authors.initials: JM
authors.lastname: Fink
authors.affiliation: Department of General, Visceral and Transplant Surgery, Centre for Metabolic Surgery, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Natalie
authors.initials: N
authors.lastname: Hoffmann
authors.affiliation: Department of General, Visceral and Transplant Surgery, Centre for Metabolic Surgery, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Kuesters
authors.affiliation: Department of General, Visceral and Transplant Surgery, Centre for Metabolic Surgery, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Seifert
authors.affiliation: Department of General, Visceral and Transplant Surgery, Centre for Metabolic Surgery, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Laessle
authors.affiliation: Department of General, Visceral and Transplant Surgery, Centre for Metabolic Surgery, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Torben
authors.initials: T
authors.lastname: Glatz
authors.affiliation: Department of General, Visceral and Transplant Surgery, Centre for Metabolic Surgery, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Ulrich T
authors.initials: UT
authors.lastname: Hopt
authors.affiliation: Department of General, Visceral, Vascular and Transplant Surgery, University of Munich, Munich, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Konrad Karcz
authors.affiliation: Department of General, Visceral and Transplant Surgery, Centre for Metabolic Surgery, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Goran
authors.initials: G
authors.lastname: Marjanovic
mesh_terms: D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000209:etiology; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D019736:Prostheses and Implants; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015431:Weight Loss
keywords: Banded sleeve; Non-adjustable band; Reflux; Sleeve gastrectomy