One Anastomosis Gastric Bypass as a Revisional Procedure After Failed Laparoscopic Adjustable Gastric Banding

Background: Recent data demonstrates that laparoscopic adjustable gastric banding (LAGB) is found to be associated with high rates of weight loss failure and long-term complications. Therefore, the search for the optimal revisional bariatric procedure is ongoing. Objective: We aim to assess the safety and efficacy of converting a failed LAGB to laparoscopic one anastomosis gastric bypass (OAGB) as a revisional procedure. Setting: Large, metropolitan, tertiary, university hospital. Methods: Retrospective review of patients who underwent OAGB after LAGB.Demographics, comorbidities, BMI before and after the procedure, complications, and length of stay were documented. Results: Fifty-seven patients underwent OAGB after LAGB. For 41 patients, the band was removed, and an OAGB was performed in a single procedure (71.9%), and 96.5% of the cases were completed laparoscopically. Postoperative complications occurred in 9 patients (15.7%), including one mortality. Average BMI decreased from 42.8 ± 7.0 to 31.3 ± 5.2 kg/m² at least 1 year after surgery, representing a mean %EWL of 64.5%. There was no statistical difference in complication rates between the 1-stage and 2-stage approach. Conclusions: Conversion of a failed LAGB to OAGB is effective but carries higher complication rates. Randomized controlled studies comparing different procedures are necessary to further clarify the optimal revisional bariatric operation.