Evaluating results of laparoscopic gastric banding surgery to manage the obesity at Viet Duc University Hospital

Introduction: Obesity is an increasing trends in Vietnam. Laparoscopic gastric band is an option to manage this problem. The aim of study is to evaluate the result of laparoscopic gastric banding for treatment of obesity in Viet Duc University Hospital Material and Methods: An uncontrolled interventional clinical trial in 71 patients underwent laparoscopic gastric banding from May 2007 to July 2017 Results: 71 patients underwent laparoscopic gastric banding enrolled in this series. Of them, prophylactic antibiotics including cefazolin was in 87.3% and cefuroxime in 12.7%. The successful rate of procedure was 100%. All patients were placed with 4 trocars. 59,2% of patients were fixed with 3 stitches to the front of stomach and 40,8% were fixed by 4 stitches to front of stomach. The postoperative complications for band migration was 1,4%. No deaths neither complications such as perforation of the esophagus and stomach were observed. Conclusion: The study found that prophylactic antibiotic is necessary, however the dosage is not needed to increase in obesity patients. The intraabdominal pressure is higher than conventional laparoscopic surgery, but it does not affect blood pressure as well as cardiovascular system. 4 trocars placed is good enough. The band needs to be fixed in order to avoid the postoperative migration. Keywords: Obesity, laparoscopic gastric banding

Revisional Bariatric Surgery

The annual volume of bariatric surgery is growing, giving rise to an increase in complications requiring complex management, including revision. Bariatric revision procedures are also becoming increasingly necessary for weight-loss recidivism and patients at the extreme of obesity. This chapter outlines clinical management pathways used to address secondary bariatric surgery. It summarizes reasons for, and outcomes with, revision of a laparoscopic gastric band, vertical banded gastroplasty, sleeve gastrectomy, or Roux-en-Y gastric bypass. Surgical techniques used to manage weight regain or failed weight loss after bariatric surgery are also discussed. Finally, surgical solutions for bariatric surgery-induced malnutrition are described, particularly in the setting of biliopancreatic diversion, duodenal switch, or jejunoileal bypass. Overall, the chapter concludes that standardization of revisional procedures can have a significant patient impact, and guidelines must be evidence-based in order to ensure patient safety and success.