[Surgical treatment of obesity. Is gastric wrapping an alternative?]

To remedy the disabling side effects of gastric banding, a group of eleven patients were re-operated with gastric wrapping. Encouraging results led us to perform primary gastric wrapping straight away in fourteen additional patients. There were few serious complications. A comparison of the performance of the two groups is based on observations four years later. In the first group, a mean body-mass-index (BMI) of 41 +/- 4 SD was noted before banding, 32 +/- 8 SD at conversion to wrap and 31 +/- 9 SD at control. The mean BMI in the second group was reduced from 40 +/- 5 SD to 32 +/- 6 SD after primary gastric wrapping. Radiographic control showed a shortening of the wraps in both groups, with pouch formation in half of the cases, uncorrelated to weight loss. It appears that gastric wrapping can be a useful revisional procedure in patients who do not tolerate gastric banding. Primary gastric wrapping produces results comparable to those of gastric banding. Modifications in our version of gastric wrapping are discussed with reference to the original method and other surgical approaches.