Laparoscopic removal of gastric banding and gastric great curvature plication simultaneously in the same operation. Presentation of a case.
EAES Academy. Koulas S. 07/05/22; 362961; P004
Dr. Spyridon Koulas
Contributions
Contributions
Abstract
The percentage of operations due to laparoscopic removable gastric banding varies greatly, ranging from 2 to 80%. Conversion to gastric bypass or laparoscopic sleeve gastrectomy, have all been investigated as re-operative procedures with varying degrees of success. Gastric banding, Roux-en-Y gastric bypass and sleeve gastrectomy are the most common bariatric surgery procedures performed worldwide. However, not all patients are willing to undergo to one of all these procedures. Laparoscopic gastric great curvature plication(LGGCP) was described several years ago and was demonstrated to be safe, with no complications and with moderate efficacy in short term.
AIM: The aim of this study is to report the efficacy and safety of laparoscopic removal of gastric banding with LGGCP.
Description of the technique: The patient, a 49-year-old man, was admitted to our hospital having endocrinologic, psychologic, caldiologic and pneumonologic report. The patient was posed in reverse Trendelenburg position of 30 degrees and four trocars, two of 11mm and two of 5mm, were positioned. At the beginning, the tube and the device of gastric banding was recognized and immediately removed. Then great omentum and short gastric vessels were carefully dissected. The great curvature was then folden, from the angle of His to the antrum (4-5cm from pylorus) using 3-0 Ethibond not absorbable sutures. Tubing of the stomach was undertaken with the use of bougie tube size 44F with two layers of interrupted sutures. Analgesia and antiemetic drugs (metoclopramide) were given in order to treat nausea and vomiting. Oral fluid intake started 8-10 hours postoperatively and progressed as was tolerated by the patient. The patient was discharged the hospital the second postoperative day. The patient was given an appropriate diet according to bariatric surgery and instructed to follow liquid diet for 2 weeks after which he was advanced to solid diet gradually.
Conclusion:
LGGCP is a safe procedure with very few postoperative complications. LGGCP shows acceptable short term weight loss. Despite the observed durability of the gastric fold, some patients regained weight. Further studies may assess the possibility of association between weight regain observed in such patients and an increase in the size of the gastric pouch.
Keywords: Gastric banding removal, Laparoscopic gastric great curvature plication
References:
1.N Khidir, M Al Dhaheri, W. El Ansari et al. Outcomes of laparoscopic gastric great curvature placation in morbidly obese patients. Journal of obesity. July 16 2017
2.Aayed R Alqahtani, Mohamed Elahmedi, Hussam Alamri. Laparoscopic removal of poor-outcome gastric banding with concomitant sleeve gastrectomy as a reoperative procedure. SAGES Abstract Archives
AIM: The aim of this study is to report the efficacy and safety of laparoscopic removal of gastric banding with LGGCP.
Description of the technique: The patient, a 49-year-old man, was admitted to our hospital having endocrinologic, psychologic, caldiologic and pneumonologic report. The patient was posed in reverse Trendelenburg position of 30 degrees and four trocars, two of 11mm and two of 5mm, were positioned. At the beginning, the tube and the device of gastric banding was recognized and immediately removed. Then great omentum and short gastric vessels were carefully dissected. The great curvature was then folden, from the angle of His to the antrum (4-5cm from pylorus) using 3-0 Ethibond not absorbable sutures. Tubing of the stomach was undertaken with the use of bougie tube size 44F with two layers of interrupted sutures. Analgesia and antiemetic drugs (metoclopramide) were given in order to treat nausea and vomiting. Oral fluid intake started 8-10 hours postoperatively and progressed as was tolerated by the patient. The patient was discharged the hospital the second postoperative day. The patient was given an appropriate diet according to bariatric surgery and instructed to follow liquid diet for 2 weeks after which he was advanced to solid diet gradually.
Conclusion:
LGGCP is a safe procedure with very few postoperative complications. LGGCP shows acceptable short term weight loss. Despite the observed durability of the gastric fold, some patients regained weight. Further studies may assess the possibility of association between weight regain observed in such patients and an increase in the size of the gastric pouch.
Keywords: Gastric banding removal, Laparoscopic gastric great curvature plication
References:
1.N Khidir, M Al Dhaheri, W. El Ansari et al. Outcomes of laparoscopic gastric great curvature placation in morbidly obese patients. Journal of obesity. July 16 2017
2.Aayed R Alqahtani, Mohamed Elahmedi, Hussam Alamri. Laparoscopic removal of poor-outcome gastric banding with concomitant sleeve gastrectomy as a reoperative procedure. SAGES Abstract Archives
The percentage of operations due to laparoscopic removable gastric banding varies greatly, ranging from 2 to 80%. Conversion to gastric bypass or laparoscopic sleeve gastrectomy, have all been investigated as re-operative procedures with varying degrees of success. Gastric banding, Roux-en-Y gastric bypass and sleeve gastrectomy are the most common bariatric surgery procedures performed worldwide. However, not all patients are willing to undergo to one of all these procedures. Laparoscopic gastric great curvature plication(LGGCP) was described several years ago and was demonstrated to be safe, with no complications and with moderate efficacy in short term.
AIM: The aim of this study is to report the efficacy and safety of laparoscopic removal of gastric banding with LGGCP.
Description of the technique: The patient, a 49-year-old man, was admitted to our hospital having endocrinologic, psychologic, caldiologic and pneumonologic report. The patient was posed in reverse Trendelenburg position of 30 degrees and four trocars, two of 11mm and two of 5mm, were positioned. At the beginning, the tube and the device of gastric banding was recognized and immediately removed. Then great omentum and short gastric vessels were carefully dissected. The great curvature was then folden, from the angle of His to the antrum (4-5cm from pylorus) using 3-0 Ethibond not absorbable sutures. Tubing of the stomach was undertaken with the use of bougie tube size 44F with two layers of interrupted sutures. Analgesia and antiemetic drugs (metoclopramide) were given in order to treat nausea and vomiting. Oral fluid intake started 8-10 hours postoperatively and progressed as was tolerated by the patient. The patient was discharged the hospital the second postoperative day. The patient was given an appropriate diet according to bariatric surgery and instructed to follow liquid diet for 2 weeks after which he was advanced to solid diet gradually.
Conclusion:
LGGCP is a safe procedure with very few postoperative complications. LGGCP shows acceptable short term weight loss. Despite the observed durability of the gastric fold, some patients regained weight. Further studies may assess the possibility of association between weight regain observed in such patients and an increase in the size of the gastric pouch.
Keywords: Gastric banding removal, Laparoscopic gastric great curvature plication
References:
1.N Khidir, M Al Dhaheri, W. El Ansari et al. Outcomes of laparoscopic gastric great curvature placation in morbidly obese patients. Journal of obesity. July 16 2017
2.Aayed R Alqahtani, Mohamed Elahmedi, Hussam Alamri. Laparoscopic removal of poor-outcome gastric banding with concomitant sleeve gastrectomy as a reoperative procedure. SAGES Abstract Archives
AIM: The aim of this study is to report the efficacy and safety of laparoscopic removal of gastric banding with LGGCP.
Description of the technique: The patient, a 49-year-old man, was admitted to our hospital having endocrinologic, psychologic, caldiologic and pneumonologic report. The patient was posed in reverse Trendelenburg position of 30 degrees and four trocars, two of 11mm and two of 5mm, were positioned. At the beginning, the tube and the device of gastric banding was recognized and immediately removed. Then great omentum and short gastric vessels were carefully dissected. The great curvature was then folden, from the angle of His to the antrum (4-5cm from pylorus) using 3-0 Ethibond not absorbable sutures. Tubing of the stomach was undertaken with the use of bougie tube size 44F with two layers of interrupted sutures. Analgesia and antiemetic drugs (metoclopramide) were given in order to treat nausea and vomiting. Oral fluid intake started 8-10 hours postoperatively and progressed as was tolerated by the patient. The patient was discharged the hospital the second postoperative day. The patient was given an appropriate diet according to bariatric surgery and instructed to follow liquid diet for 2 weeks after which he was advanced to solid diet gradually.
Conclusion:
LGGCP is a safe procedure with very few postoperative complications. LGGCP shows acceptable short term weight loss. Despite the observed durability of the gastric fold, some patients regained weight. Further studies may assess the possibility of association between weight regain observed in such patients and an increase in the size of the gastric pouch.
Keywords: Gastric banding removal, Laparoscopic gastric great curvature plication
References:
1.N Khidir, M Al Dhaheri, W. El Ansari et al. Outcomes of laparoscopic gastric great curvature placation in morbidly obese patients. Journal of obesity. July 16 2017
2.Aayed R Alqahtani, Mohamed Elahmedi, Hussam Alamri. Laparoscopic removal of poor-outcome gastric banding with concomitant sleeve gastrectomy as a reoperative procedure. SAGES Abstract Archives
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