Page 52 - World Journal of Laparoscopic Surgery

ORIGINAL ARTICLE
Conversion to a Banded Gastric Bypass is a Safe and Effective

Option after Sleeve Gastrectomy: A Indian Single-center

Experience

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Mahak Bhandari , Susmit Kosta , Manoj Reddy , Winni Mathur , Mohit Bhandari 5
AbstrAct
Revision bariatric surgery has become a standard technique in bariatric surgery processes. Patients who have experienced insufficient weight
reduction or subsequent weight gain following an initial surgery have a variety of options for revision. The objective of this report was to explore
the role of a sleeve gastrectomy (SG) revision to a banded gastric bypass (BGBP) for inadequate weight loss or weight gain. Patients who had
BGBP revision surgery after SG were identified in a prospectively kept database and information on comorbidity resolution and weight was
obtained. The effects of the revision activities were evaluated and analyzed. Sixty-two patients underwent reconsideration of SG to BGBP. The
average time for the revision was 27 months in the range 7–60 and the follow-up after BGBP was 6–36 months. In this study the average initialism
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weight before the SG was 113.5 ± 20.5 kg and the body mass index (BMI) was 41.71 ± 8.1 kg/m . The mean percentage of weight loss %TWL
at revision and at the nadir weight was 18.5 and 13.5%, respectively. The average %TWL was 25.9 ± 10.1, 29.7 ± 9.2, and 26.9 ± 9.6 at first-,
second-, and third-year follow-up, respectively, after revision to BGBP. Type II diabetes (T2D) and hyperaeration (HTN) were resolved in 70 and
78.6% of the patients, respectively. With no complications or mortality AI revisions were done laparoscopically. It is practically feasible and safe
to switch from SG to BGBP. The weight reduction from the BGBP sleeve is not only more desired than the weight loss from the primary sleeve, but
it also results in successful comorbidity resolution. BGBP is a better bet to changing for altering SG for insufficient weight regain or weight loss.
Keywords: Banded gastric bypass, Insufficient weight-loss, Revision, Sleeve gastrectomy.
World Journal of Laparoscopic Surgery (2022): 10.5005/jp-journals-10033-1503

IntroductIon 1,3 Department of Surgery, Sri Aurobindo Medical College and PG
As a primary weight loss procedure, the sleeve gastrectomy Institute, Indore, Madhya Pradesh, India
(SG) has gained growing acceptability as a safe and effective 2 Central Research Lab, Sri Aurobindo Institute of Medical Sciences,
surgery for morbid obesity. Good weight reduction, resolution of Indore, Madhya Pradesh, India
comorbidities, a very straightforward surgery with a short operation 4,5 Department of Surgery, Mohak Bariatrics and Robotics, Indore,
time, and a low incidence of complications are all advantages of Madhya Pradesh, India
laparoscopic SG. Over the years, several bariatric surgeons have Corresponding Author: Mahak Bhandari, Department of Surgery, Sri
contemplated it as a standard bariatric operation. Despite many Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh,
advantages following SG, as with all other bariatric procedures, India, e-mail: emailmahak@gmail.com
with time and increased number of cases performed, After the How to cite this article: Bhandari M, Kosta S, Reddy M, et al. Conversion
SG, significant numbers of patients experience insufficient weight to a Banded Gastric Bypass is a Safe and Effective Option after Sleeve
loss and weight return. 1–3 Patients who require revision due to Gastrectomy: A Indian Single-center Experience. World J Lap Surg
insufficient weight reduction or weight gain have had endoscopic 2022;15(1):50–53.
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plication, surgical re-SG, or both, or a Roux-en-Y gastric bypass Source of support: Nil
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(RYGB), one anastomosis gastric bypass (OAGB), banded gastric
bypass (BGBP), or biliopancreatic diversion with a duodenal switch Conflict of interest: None
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(BPD-DS). We offer patients with sleeves who have inadequate
weight loss or significant weight regain revision to a BGBP based on India. Patients who had a SG and subsequent revision to BGBP
our experience with the BGBP, which we have reported to provide between February 2009 and December 2019 were identified from
better weight loss than the RYGB and systematic analysis has shown the database. The patient profile, age, gender, BMI, comorbid
the BGBP to be equivalent to the BPD-DS. This retrospective study conditions, the year of the first operation, the year of the revision,
was conducted to investigate the result of SG to BGBP revision for the starting weight, the weight at the time of the revision, the
insufficient weight loss and weight recovery in our experience with weight 3 years later, additional comorbidity resolution, and
up to 3 years of follow-up after the revision. complications, if any, were also recorded.
MAterIAls And Methods Surgical Technique
This is a retrospective analysis of data gathered from a prospectively All of the initial and revision surgeries were performed
maintained database at a dedicated high-volume bariatric center, laparoscopically. There was no conversion to open surgery.

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