Dr. says revision success not as good!!!
Jane
** Ticker shows weight loss since Day of Revision Surgery **
on 11/22/07 11:01 pm - Tuvalu
In any group of a hundred people, there are probably 2 or 3 sociopaths. In a group of a thousand, more like 20-30. They function very well in "affinity groups," where people have things in common and tend to trust strangers. I am NOT saying not to trust anyone. I AM saying that there are probably two dozen sociopaths hanging out here and looking for victims. Most are NOT serial killers.
Read: www.sociopathicstyle.com/traits/classic.htm
Lap-Band June 14, 2001. Dr. Rumbaut, Monterrey, Mexico.
Lap-Band removed after 7 years and converted to Sleeve Gastrectomy on July 7, 2008 by Dr. Roslin. I've had three happy healthy Lap-Band babies.... and one VSG baby. 5 years out from revision to VSG. Gained 55 pounds in past 5 months, now considering DS. :(
- Surg Endosc. 2007 Aug;21(8):1388-92. Epub 2007 Mar 14.
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Laparoscopic revision from LAP-BAND to gastric bypass.
Spivak H, Beltran OR, Slavchev P, Wilson EB.Department of Surgery, Park-Plaza Hospital, Houston, TX, USA. [email protected]
BACKGROUND: While the majority of patients achieve good outcomes with the LAP-BAND, there is a subset of patients who experience complications or fail to lose sufficient weight after the banding procedure. This study examines the feasibility and outcome of performing laparoscopic Roux-en-Y gastric bypass (RYGBP) as a single-step revision surgery after a failed LAP-BAND procedure. METHODS: In the past five years we have performed more than 1400 LAP-BAND procedures. We laparoscopically converted 33 (30 females) of these patients (mean age = 43.8 years) from LAP-BAND to RYGBP because of inadequate weight loss and/or complications. Key steps in the revision procedures were (1) identification and release of the band capsule; (2) careful dissection of the gastrogastric sutures; (3) creation of a small gastric pouch; and (4) Roux-en-Y anterior colic anterior gastric pouch-jejunum anastomosis. Revisions took place at a mean 28.2 months (range = 11-46; SD = 11.3) after the original gastric banding. Change in body mass index (BMI) between pre- and postrevision was evaluated with paired t tests. RESULTS: Among the 33 patients who would undergo revision surgery, the mean BMI before the LAP-BAND procedure was 45.7 kg/m2 (range = 39.9-53.0; SD = 3.4) and the mean weight was 126 kg (range = 99-155; SD = 17). The lowest BMI achieved by this group with the LAP-BAND before revision was 39.7 kg/m2 (range = 30-49.2; SD = 4.9); however, the mean BMI at the time of revision was 42.8 kg/m2 (range = 33.1-50; SD = 4.8). The mean revision operative time was 105 min (range = 85-175), and the mean hospital stay was 2.8 days (range = 1-10). Complications included one patient who underwent open reoperation and splenectomy for a bleeding spleen and one patient *****quired repair of an internal hernia. After conversion to RYGBP, mean BMI decreased to 33.9 kg/m2 at 6 months (p < 0.001) and 30.7 kg/m2 (range = 22-39.6; SD = 5.3) at 12 months or more of followup (average = 15.7 months; p < 0.0001). CONCLUSIONS: Laparoscopic conversion from LAP-BAND to RYGBP is safe and can be an alternative for patients who failed the LAP-BAND procedure. However, revision surgery is technically challenging and should be performed only by surgeons who have completed the learning curve for laparoscopic RYGBP.
PMID: 17356943 [PubMed - indexed for MEDLINE]
Lap-Band June 14, 2001. Dr. Rumbaut, Monterrey, Mexico.
Lap-Band removed after 7 years and converted to Sleeve Gastrectomy on July 7, 2008 by Dr. Roslin. I've had three happy healthy Lap-Band babies.... and one VSG baby. 5 years out from revision to VSG. Gained 55 pounds in past 5 months, now considering DS. :(
- Obes Surg. 2006 Feb;16(2):137-41.
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Revision of failed laparoscopic adjustable gastric banding to Roux-en-Y gastric bypass.
van Wageningen B, Berends FJ, Van Ramshorst B, Janssen IF.Department of Surgery, Rijnstate Hospital, The Netherlands. [email protected]
BACKGROUND: The most common bariatric surgical operation in Europe, laparoscopic adjustable gastric banding (LAGB), is reported to have a high incidence of long-term complications. Also, insufficient weight loss is reported. We investigated whether revision to Roux-en-Y gastric bypass (RYGBP) is a safe and effective therapy for failed LAGB and for further weight loss. METHODS: From Jan 1999 to May 2004, 613 patients underwent LAGB. Of these, 47 underwent later revisional Roux-en-Y gastric bypass (RYGBP). Using a prospectively collected database, we analyzed these revisions. All procedures were done by two surgeons with extensive experience in bariatric surgery. RESULTS: All patients were treated with laparoscopic (n=26) or open (n=21) RYGBP after failed LAGB. Total follow-up after LAGB was 5.5+/-2.0 years. For the RYGBP, mean operating time was 161+/-53 minutes, estimated blood loss was 219+/-329 ml, and hospital stay was 6.7+/-4.5 days. There has been no mortality. Early complications occurred in 17%. There was only one late complication (2%)--a ventral hernia. The mean BMI prior to any form of bariatric surgery was 49.2+/-9.3 kg/m2, and decreased to 45.8+/-8.9 kg/m2 after LAGB and was again reduced to 37.7+/-8.7 kg/m2 after RYGBP within our follow-up period. CONCLUSION: Conversion of LAGB to RYGBP is effective to treat complications of LAGB and to further reduce the weight to healthier levels in morbidly obese patients.
PMID: 16469213 [PubMed - indexed for MEDLINE]
Lap-Band June 14, 2001. Dr. Rumbaut, Monterrey, Mexico.
Lap-Band removed after 7 years and converted to Sleeve Gastrectomy on July 7, 2008 by Dr. Roslin. I've had three happy healthy Lap-Band babies.... and one VSG baby. 5 years out from revision to VSG. Gained 55 pounds in past 5 months, now considering DS. :(
- Obes Surg. 2004 Nov-Dec;14(10):1349-53.
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Laparoscopic conversion of laparoscopic gastric banding to Roux-en-Y gastric bypass: a review of 70 patients.
Mognol P, Chosidow D, Marmuse JP.Service de chirurgie générale A, CHU Bichat-Claude Bernard, Paris, France.
BACKGROUND: The feasibility and outcomes of conversion of laparoscopic adjustable gastric banding (LAGB) to laparoscopic Roux-en-Y gastric bypass (LRYGBP) was evaluated. METHODS: From November 2000 to March 2004, all patients who underwent laparoscopic conversion of LAGB to LRYGBP were retrospectively analyzed. The procedure included adhesiolysis, resection of the previous band, creation of an isolated gastric pouch, 100-cm Roux-limb, side-to-side jejuno-jejunostomy, and end-to-end gastro-jejunostomy. RESULTS: 70 patients (58 female, mean age 41) with a median BMI of 45+/-11 (27-81) underwent attempted laparoscopic conversion of LAGB to an RYGBP. Indications for conversion were insufficient weight loss or weight regain after band deflation for gastric pouch dilatation in 34 patients (49%), inadequate weight loss in 17 patients (25%), symptomatic proximal gastric pouch dilatation in 15 patients (20%), intragastric band migration in 3 patients (5%), and psychological band intolerance in 1 patient. 3 of 70 patients (4.3%) had to be converted to a laparotomy because of severe adhesions. Mean operative time was 240+/-40 SD min (210-280). Mean hospital length of stay was 7.2 days. Early complication rate was 14.3% (10/70). Late major complications occurred in 6 patients (8.6%). There was no mortality. Median excess body weight loss was 70+/-20%. 60% of patients achieved a BMI of <33 with mean follow-up 18 months. CONCLUSION: Laparoscopic conversion of LAGB to RYGBP is a technically challenging procedure that can be safely integrated into a bariatric treatment program with good results. Short-term weight loss is very good.
PMID: 15603650 [PubMed - indexed for MEDLINE]
Lap-Band June 14, 2001. Dr. Rumbaut, Monterrey, Mexico.
Lap-Band removed after 7 years and converted to Sleeve Gastrectomy on July 7, 2008 by Dr. Roslin. I've had three happy healthy Lap-Band babies.... and one VSG baby. 5 years out from revision to VSG. Gained 55 pounds in past 5 months, now considering DS. :(