Laparoscopic Adjustable Gastric Banding with the Adhesix® Bioring® for Weight Regain or Insufficient Weight Loss After a Roux-en-Y Gastric Bypass: Midterm Data from the Pronto Registry

Background and Aims: Personality disorders are frequently associated with eating disorders in obese patients and may negatively affect weight loss and maintenance after bariatric surgery. This non-randomized study aimed to assess the effects of different psychotherapeutic interventions on weight loss in a sample of patients with borderline personality disorder who underwent laparoscopic gastric bypass or laparoscopic adjustable gastric banding. Materials and Methods: A total of 153 bariatric patients meeting borderline personality disorder criteria were chosen voluntarily and consecutively to undergo an interpersonal individual treatment (n = 50), a dialectical behavioral group treatment (n = 50), or treatment as usual (n = 53) for a year after surgery. Their body mass index was measured before and at the end of each treatment. Results and Conclusion: A total of 12 patients (7.8%) dropped out of the study. Significantly higher body mass index reductions were registered in both experimental groups (−14.2 and −9.4 kg/m2, respectively) compared with the treatment as usual group (−2.1 kg/m2; p < 0.01). Treated patients who underwent laparoscopic gastric bypass (total n = 94) showed better outcomes than those who underwent laparoscopic adjustable gastric banding (total n = 45), while no differences were observed in untreated patients. This study demonstrates the role of pre-operative psychological assessment and post-operative psychotherapeutic support in improving weight loss among bariatric patients with borderline personality disorder. A randomized controlled trial is needed to confirm these preliminary findings.

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Laparoscopic Adjustable Gastric Band: Complications, Removal and Revision in a Portuguese Highly Differentiated Obesity Treatment Center

Acta Médica Portuguesa ◽

10.20344/amp.6369 ◽

2015 ◽

Vol 28 (6) ◽

pp. 735 ◽

Cited By ~ 2

Author(s):

Alfredo Mendes-Castro ◽

Joana Montenegro ◽

Jorge Félix Cardoso ◽

Gisela Simões ◽

Catarina Ferreira ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Gastric Banding ◽

Laparoscopic Sleeve Gastrectomy ◽

Laparoscopic Adjustable Gastric Banding ◽

Revision Surgery ◽

Adjustable Gastric Banding ◽

Laparoscopic Adjustable Gastric Band ◽

Treatment Center

Introduction: Our objective is to determine which complications lead to reoperation, and the outcomes of reoperation using laparoscopic adjustable gastric banding, laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy at Centro Hospitalar de São João. Material and Methods: Observational study. Patients included were aged 18 to 65 years at first gastric banding, underwent removal from March 21st 2007 to January 23rd 2014 and were subsequently converted to gastric banding, gastric bypass or sleeve gastrectomy. Women who got pregnant during the initial gastric banding follow-up and patients that performed more than one conversion were excluded. Results: A total of 103 patients were included. Fifteen underwent revision to gastric banding, 71 to gastric bypass and 17 to sleeve gastrectomy. Respectively, percentage of excess weight loss at 1 month were 1.9 ± 12.2% in 6 patients, 36.9 ± 18.2% in 49 patients and 27.1% (13.3 - 68.6) in 11 patients (laparoscopic adjustable-gastric banding-laparoscopic Roux-en-Y gastric bypass p < 0.001, laparoscopic adjustable-gastric banding-laparoscopic sleeve gastrectomy p = 0.002 and laparoscopic Roux-en-Y gastric bypass-laparoscopic sleeve gastrectomy p = 0.474). At 3 months there were 12.8% (5.7 - 84.8) in 6 patients, 44.8 ± 19.7% in 24 patients and 48 ± 20.1% in 8 patients (laparoscopic adjustable-gastric banding-laparoscopic Roux-en-Y gastric bypass p = 0.017, laparoscopic adjustable-gastric banding-laparoscopic sleeve gastrectomy p = 0.039 and laparoscopic Roux-en-Y gastric bypass-laparoscopic sleeve gastrectomy p = 0.691). Discussion: At revision, ages and body mass indices are higher than other studies. Gastric bypass is the preferred revision surgery, because combines restriction and malabsorption, surgeons have more experience and long term outcomes are better described. Conclusions: The main indications for reoperation were inadequate weight loss (37.4%) and band slippage (30%). At short term, in our patients, gastric banding as a revision surgery was not effective, as opposed to gastric bypass and sleeve gastrectomy.

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