Outcomes of revision laparoscopic gastric banding: a retrospective study

Obesity is a health problem approaching pandemic proportions. Laparoscopic adjustable gastric banding (LAGB) is the bariatric procedure of choice in Australia for effective surgical treatment of severe obesity. Complications of LAGB lead to a high proportion of patients requiring revision surgery. However, literature regarding outcomes and failure rates of revision bariatric surgery is scarce, such that the choice of procedure at reoperation remains controversial. This paper aims to present outcomes of revision laparoscopic gastric banding.

One hundred eighty-three consecutive revision LAGB procedures were performed in 163 patients between March 1998 and July 2009. Patients were followed up for a median period of 36 months. Weight change in terms of body mass index (BMI) and percentage excess weight loss (%EWL), morbidity and patient tolerance were examined.

The average reduction in BMI from the primary LAGB procedure was 8.45 kg/m(2) , equivalent to a %EWL of 50.55. BMI of patients who underwent revision LAGB appears to remain stable, with mean change of +0.25 kg/m(2) (%EWL 45.76, P = 0.5) at 3 years and -1.59 (%EWL 51.52, P = 0.12) at 5 years. The overall complication rate of revision LAGB was 13.7%, most commonly recurrent gastric pouch dilatation.

Revision LAGB is reasonably well tolerated by most patients. Preliminary outcome data indicate that revision gastric banding does not result in further weight loss in patients who have lost weight from primary banding, but does maintain the weight loss achieved.