Laparoscopic sleeve gastrectomy (LSG) is being used as a revisional procedure for patients who have failed gastric banding due to inadequate weight loss or complications. This study evaluated 44 patients who underwent LSG after a failed laparoscopic adjustable gastric banding (LAGB). The results showed that LSG can be performed safely as a one-stage procedure with a mean operative time of 96 minutes and hospital stay of 3 days. Patients experienced a mean excess weight loss of 76.9% at 16 months follow-up. LSG is an effective option for revisional surgery after LAGB failure that can be performed safely and results in significant weight loss.

1. Sleeve Gastrectomy as a Revisional
Procedure for Failed Gastric Banding
Berry M, Urrutia L, Lamoza P, Rossi R
Bariatric and Metabolic Surgical Unit
Clínica Las Condes
Santiago, Chile

2. Introduction
• Laparoscopic sleeve gastrectomy (LSG) has been
recognized as a good treatment option for obesity and its
comorbidities.
• Revision of a failed laparoscopic adjustable gastric
banding (LAGB) has become a common situation in
bariatric surgery and the best procedure to be offered is
still under debate.

3. Introduction
• Main indications for revisional surgery after LAGB:
– Inadequate weight loss
– Band Problems
• Slippage
• Malfunction of the tube-reservoir
• Esophageal Dilatation
• Pouch Dilatation
– Poor quality of life
• It is well known than succesful LAGB patients who require band
removal gain weight thereafter.
• In most cases, a new procedure is required to fulfill our
objective: weight loss maintenance.

4. Objective
• To evaluate our results of a one-stage procedure, with
conversion of a LAGB to a LSG as a revisional
procedure for inadequate weight loss and/or
complications after LAGB.
• We analyze patient characteristics, operative time,
hospital stay, % EBMIL, and morbimortality.

5. Results
N: 44 27 Fem 17 Male
Age years (20-62), were operated.
43.6
(20-62)
BMI 35
(28 - 44)
Years between LAGB to 3.5 ± 0.6
LSG

6. Results
• Mean Op. Time: 96 min. (90-180)
• Conversions: 0
• Morbidity: 3 patients (6.8%)
Treatment
• Dysphagia: 1 Endoscopy
• Persistent fever: 1 Laparoscopy: (-)REOP
• Perigastric haematoma: 1 Non-operative
• Mortality: 0%
• Median Hospital Stay: 3 days

7. Results
BMI and % EBMIL
Preop Postop
35 ± 3.7 29.6 ± 2.2
BMI (Kg/m2)
(28-44) (22-39)
% EBMIL 76.9 ± 12.1
Mean follow-up: 16 months (6-34)

8. Conclusions
• LSG as a revisional surgery for a failed LAGB can
be performed safely as a one stage procedure by
experienced bariatric surgeons, and is effective as
a weight loss procedure
• Further follow-up of revisional LSG is necessary to
establish its long-term efficacy.

9. Thank you for your attention