Hmm....

"ADJUSTABLE GASTRIC BANDING AS A

REVISIONAL BARIATRIC PROCEDURE AFTER FAILED GASTRIC BYPASS.

Marc Bessler, MD, Amna Daud, MD, MPH, Lorraine Olivero- Rivera,

FNPCS, Daniel Davis, DO Center for Obesity Surgery, New York-

Presbyterian Hospital, Columbia University and Lawrence Hospital, New

York, New York, USA

BACKGROUND: Inadequate weight loss after proximal gastric bypass

presents a clinical challenge to bariatric surgeons. Pouch size,

stoma size and limb length are the variables that can be surgically

altered. Aside from conversion to distal bypass, which may have

significant negative nutritional sequel, revisional surgery for this

group of patients has not often been reported. The addition of

Adjustable Silicone Gastric Banding (ASGB) to Gastric Bypass (GBP)

may be a useful revision strategy as it has potential safety benefit

ts over other revisional approaches.

Methods: We report on 7 patients who presented with inadequate weight

loss or significant weight regain after proximal gastric bypass. All

patients underwent revision with the placement of an Adjustable

Silicone Gastric Band around the proximal gastric pouch. Bands were

adjusted at 6 weeks post operatively and beyond as needed.

Complications and weight loss at the most recent follow up visit were

evaluated.

Results: Mean age and Body Mass Index (BMI) at the time of revision

was 36.7 (30-49) years and 45.7 ± 3.32 (kglm2) respectively. No

patients were lost to follow up, which ranged from 8 weeks to 20

months (mean follow up=7.6

months) and they lost 15%-45% (mean %EWL=282%) of their excess weight

respectively. The only complication was the development of a seroma

overlying the area of port adjustment in one patient. There have been

no erosions or band slippages associated with the band.

Conclusion: These results indicate that the addition of the ASGB

causes significant weight loss in patients with poor weight loss

outcome after gastric bypass. The fact that no anastomosis or change

in absorption is required may make this an attractive revisional

strategy. Further evaluation in a larger population is warranted."

So those fancy pants Drs. are just know figuring out what we already knew! Wow, aren't we smart!

Leatha - Thanks for posting that article, it makes me feel good about the decision I made.

Betty