Adjustable gastric band placed around gastric bypass pouch as revision operation for failed gastric bypass

The failure rate after gastric bypass surgery for weight loss has been reported at 10-20%. To date, no reliably safe and effective salvage operation is available. This pilot study was conducted to determine whether restriction of the Roux-en-Y gastric bypass (RYGB) pouch using the adjustable gastric band (AGB) is an effective revision operation.

A prospectively accrued group of patients who underwent revisional surgery using the AGB placed around the RYGB pouch by our bariatric surgical group from October 2004 to October 2006 was analyzed.

Of the 10 patients accrued during this period, 2 were lost to follow-up, leaving 8 patients for analysis. Of the 8 patients, 1 was a man and 7 were women. The mean prerevision weight was 135.75 kg (range 105-165), and the body mass index was 48.42 kg/m(2) (range 38.92-55). The mean weight loss at 1 year of follow-up was 17.03 kg (range 0.2-42), with a mean percentage of excess weight loss of 24.29% (range 0.2-49.2%). The mean weight loss of the 5 patients with 2 years of follow-up was 36.4 kg (range 20-58), with a mean percentage of excess weight loss of 48.7% (range 21.8-98.1%). One patient with 3 years of follow-up had a weight loss of 56 kg and a percentage of excess weight loss of 66.2%. Three minor complications developed: 2 AGB port-related complications requiring port revision and 1 postoperative wound hematoma requiring evacuation. No band erosions or band slippages occurred, and no major complications developed.

In our study, an AGB placed around the RYGB pouch was a safe and effective revision operation for a failed RYGB operation.