Laparoscopic Sleeve Gastrectomy versus Laparoscopic Banded Sleeve Gastrectomy: First Prospective Pilot Randomized Study

Valeria Tognoni, Domenico Benavoli, Emanuela Bianciardi, Federico Perrone, Simona Ippoliti, Achille Gaspari, Paolo Gentileschi, Valeria Tognoni, Domenico Benavoli, Emanuela Bianciardi, Federico Perrone, Simona Ippoliti, Achille Gaspari, Paolo Gentileschi

Abstract

Introduction. The placement of ring or band around the gastric tube might prevent the dilation after Laparoscopic Sleeve Gastrectomy (LSG). We describe the first randomized study comparing LSG and Laparoscopic Banded Sleeve Gastrectomy (LBSG). Material and Method. Fifty obese patients were enrolled in the study between January 2014 and January 2015. We analysed differences in operative time, complication rate, mortality, and BMI between the two groups over a period of 12 months. Results. Twenty-five patients received LSG (group A) and 25 LBSG (group B). The mean preoperative BMI was 47.3 ± 6.58 kg/m(2) and 44.95 ± 5.85 kg/m(2), respectively, in the two groups. There was no statistical relevant difference in operative time. No intraoperative complications occurred. Mean BMI registered after 3, 6, and 12 months in groups A and B, respectively, were 37.86 ± 5.72 kg/m(2) and 37.58 ± 6.21 kg/m(2) (p = 0.869), 33.64 ± 6.08 kg/m(2) and 32.03 ± 5.24 kg/m(2) (p = 0.325), and 29.72 ± 4.40 kg/m(2) and 27.42 ± 4.47 kg/m(2) (p = 0.186); no statistical relevant difference was registered between the two groups. Conclusion. LBSG is a safe and feasible procedure. The time required for the device positioning did not influence significantly the surgical time. The results of bodyweight loss did not document any statistically significant differences among the two groups, even though LBSG group showed a mean BMI slightly lower than that of the control group.

Figures

Figure 1
Figure 1
Diagram of patients selection.
Figure 2
Figure 2
Laparoscopic Sleeve Gastrectomy with GaBP Ring Autolock™ System.
Figure 3
Figure 3
GaBP Ring Autolock System.

References

    1. Buchwald H., Oien D. M. Metabolic/bariatric surgery worldwide 2011. Obesity Surgery. 2013;23(4):427–436. doi: 10.1007/s11695-012-0864-0.
    1. Langer F. B., Bohdjalian A., Felberbauer F. X., et al. Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Obesity Surgery. 2006;16(2):166–171. doi: 10.1381/096089206775565276.
    1. Cesana G., Uccelli M., Ciccarese F., Carrieri D., Castello G., Olmi S. Laparoscopic re-sleeve gastrectomy as a treatment of weight regain after sleeve gastrectomy. World Journal of Gastrointestinal Surgery. 2014;6(6):101–106. doi: 10.4253/wjge.v6.i4.101.
    1. Karcz W. K., Karcz-Socha I., Marjanovic G., et al. To band or not to band—early results of banded sleeve gastrectomy. Obesity Surgery. 2014;24(4):660–665. doi: 10.1007/s11695-014-1189-y.
    1. Alexander J. W., Martin Hawver L. R., Goodman H. R. Banded sleeve gastrectomy-initial experience. Obesity Surgery. 2009;19(11):1591–1596. doi: 10.1007/s11695-009-9964-x.
    1. Agrawal S., Van Dessel E., Akin F., Van Cauwenberge S., Dillemans B. Laparoscopic adjustable banded sleeve gastrectomy as a primary procedure for the super-super obese (body mass index > 60 kg/m2) Obesity Surgery. 2010;20(8):1161–1163. doi: 10.1007/s11695-010-0188-x.
    1. Fobi M. A. Placement of the GaBP ring system in the banded gastric bypass operation. Obesity Surgery. 2005;15(8):1196–1201. doi: 10.1381/0960892055002167.
    1. Moon R. C., Teixeira A. F., Jawad M. A. Treatment of weight regain following roux-en-y gastric bypass: revision of pouch, creation of new gastrojejunostomy and placement of proximal pericardial patch ring. Obesity Surgery. 2014;24(6):829–834. doi: 10.1007/s11695-014-1188-z.
    1. Fobi M. A. L., Lee H., Felahy B., Che-Senge K., Fields C. B., Sanguinette M. C. Fifty consecutive patients with the GaBP ring system used in the banded gastric bypass operation for obesity with follow up of at least 1 year. Surgery for Obesity and Related Diseases. 2005;1(6):569–572. doi: 10.1016/j.soard.2005.09.008.
    1. Fobi M. A. L., Lee H., Fleming A. W. The surgical technique of the banded Roux-en-Y gastric bypass. Journal of Obesity and Weight Regulation. 1989;8:99–102.
    1. Buchwald H. Consensus conference statement bariatric surgery for morbid obesity: health implications for patients, health professionals, and third-party payers. Surgery for Obesity and Related Diseases. 2005;1(3):371–381. doi: 10.1016/j.soard.2005.04.002.
    1. Noel P., Nedelcu M., Nocca D., et al. Revised sleeve gastrectomy: another option for weight loss failure after sleeve gastrectomy. Surgical Endoscopy. 2014;28(4):1096–1102. doi: 10.1007/s00464-013-3277-9.
    1. Nedelcu M., Noel P., Iannelli A., Gagner M. Revised sleeve gastrectomy (re-sleeve) Surgery for Obesity and Related Diseases. 2015;11(6):1282–1288. doi: 10.1016/j.soard.2015.02.009.
    1. Awad W., Garay A., Martínez C. Ten years experience of banded gastric bypass: does it make a difference? Obesity Surgery. 2012;22(2):271–278. doi: 10.1007/s11695-011-0555-2.
    1. Capella J. F., Capella R. F. An assessment of vertical banded gastroplasty-Roux-en-Y gastric bypass for the treatment of morbid obesity. The American Journal of Surgery. 2002;183(2):117–123. doi: 10.1016/s0002-9610(01)00871-6.
    1. Burton P. R., Brown W. A. The mechanism of weight loss with laparoscopic adjustable gastric banding: Induction of satiety not restriction. International Journal of Obesity. 2011;35(supplement 3):S26–S30. doi: 10.1038/ijo.2011.144.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir