Use of adjustable silicone gastric banding for revision of failed gastric bariatric operations

Background: Revision of gastric bariatric operations is sometimes technically difficult and may fail to achieve prolonged weight reduction. The use of the adjustable silicone gastric banding (ASGB) offers a new approach for these revisions. Methods: ASGB was performed as a revisional procedure on 37 patients whose initial bariatric operations were as follows: silastic ring vertical gastroplasty (21), gastric bypass (12), horizontal gastroplasty (3) and vertical banded gastroplasty (1). Results: The length of the procedure varied from 55 to 145 minutes (mean 83 minutes). Intraoperative complications included two fundic tears which were sutured without any postoperative sequelae. Five patients needed reoperation during the first postoperative year due to gastric volvulus (1), tubing tear (1) and development of postoperative ventral hernia (3). BMI fell from 44.8 ± SD 8.07 to 33.4 ± 6.9 kg/m² for patients operated with BMI higher than 35 kg/m² and from 29.2 ± 3.32 to 25.4 ± 2.8 kg/m² for patients operated with BMI lower than 35 kg/m². Conclusions: ASBG can be performed with revisions with an acceptable complication rate and postoperative weight reduction.