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Laparoscopic Mini-Gastric Bypass for Failed Vertical Banded Gastroplasty
LMGB is Effective Revision Operation After Ineffective Stomach Stapling
Laparoscopic Mini-Gastric Bypass for Failed Vertical Banded Gastroplasty
Bariatric surgery is the only method for sustained weight loss in morbid obesity. However, 10-25% of patients will require re-operation for unsatisfactory weight loss or weight regain after restrictive surgery. Re-operation is associated with higher morbidity and mortality. This study is to evaluate the safety and efficacy of laparoscopic mini-gastric bypass (LMGB) for failed vertical banded gastroplasty (VBG).
From May 2001 to March 2003, 29 consecutive patients underwent laparoscopic mini-gastric bypass for failed vertical banded gastroplasty. Average age was 39.7 years (range 22 to 56), and average BMI before re-operation was 41.7 kg/m(2) (range 35.0-70.8). 8 patients had previous open VBG, and 21 had laparoscopic vertical banded gastroplasty. The re-operation was for regain of weight in 16 patients, inadequate weight loss in 10 patients, and severe reflux esophagitis in 3 patients. Re-operation was performed after an average of 58.5 months (range 14 to 180).
All the re-operations were completed laparoscopically. Average operative time was 171.4 minutes (range 130 to 290). There was 1 mortality, due to leakage (3.4%). 1 re-operation was necessary, for incarceration of small bowel in a trocar wound 10 days after the laparoscopic mini-gastric bypass (3.4%). 1 anastomotic site bleeding and 1 wound infection occurred. Average BMI 12 months after the laparoscopic mini-gastric bypass was 32.1 kg/m(2) (range 26.4 to 42.7). The quality of life study was significantly improved. The revision operation had much more technical difficulty for those with previous open vertical banded gastroplasty than laparoscopic vertical banded gastroplasty.
Laparoscopic mini-gastric bypass is an effective and safe revision operation for patients with failed vertical banded gastroplasty. A large series and long-term follow up is needed for confirmation.
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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2017 Bariatric-Surgery.Info - Terms - Contact - Information - Resources