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Banding the Sleeve Improves Weight Loss in Midterm Follow-up

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Abstract

Introduction

Laparoscopic sleeve gastrectomy (LSG) can achieve excellent weight loss, yet sleeve dilatation with concomitant weight regain proves to be a relevant issue. Hence, additional restriction might improve results after LSG.

Methods

In a retrospective matched-pair analysis, 42 patients who underwent banded LSG (BLSG) using a MiniMizer® ring between January 2012 and October 2014 were analysed regarding weight loss, complications and comorbidity. Median follow-up was 3 years. Forty-two patients who had undergone conventional LSG were selected as matched pairs.

Results

Mean preoperative BMI was 54.93 ± 7.42 kg/m2 for BLSG and 53.46 ± 6.69 kg/m2 for LSG (Mann-Whitney P = 0.540). Total weight loss (%TWL) was significantly greater in the BLSG group 3 years after surgery (BLSG 38.22% ± 7.26; n = 26 vs. LSG 32.69 ± 9.47; n = 26; P = 0.0154). Ring placement had no relevant impact on new-onset reflux (Fisher’s exact test P = 1.0) but a tendency towards reflux improvement when reflux pre-existed (odds ratio 1.96). The major side effect of ring implantation was regurgitation with over 44% of patients presenting with regurgitation >1 per week (Fisher’s exact test P = 0.0019, odds ratio 18.07).

Conclusion

BLSG is a safe procedure showing similar comorbidity to conventional LSG. However, BLSG leads to a higher rate of postoperative regurgitation. Weight loss is significantly improved 3 years after surgery. Hence, additional ring implantation might be an option for increased restriction in LSG surgery.

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Author information

Authors and Affiliations

  1. Department of General, Visceral and Transplant Surgery, Centre for Metabolic Surgery, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany

    Jodok M. Fink, Natalie Hoffmann, Simon Kuesters, Gabriel Seifert, Claudia Laessle, Torben Glatz, Ulrich T. Hopt & Goran Marjanovic

  2. Department of General, Visceral, Vascular and Transplant Surgery, University of Munich, Munich, Germany

    W. Konrad Karcz

Authors
  1. Jodok M. Fink
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  2. Natalie Hoffmann
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  3. Simon Kuesters
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  4. Gabriel Seifert
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  5. Claudia Laessle
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  6. Torben Glatz
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  7. Ulrich T. Hopt
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  8. W. Konrad Karcz
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  9. Goran Marjanovic
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Corresponding author

Correspondence to Jodok M. Fink.

Ethics declarations

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from all individual participants included in the study. The institutional ethics committee approved retrospective data evaluation of all patients (Ref. number: 321/13).

Conflict of Interest

The authors declare that they have no conflicts of interests.

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Fink, J.M., Hoffmann, N., Kuesters, S. et al. Banding the Sleeve Improves Weight Loss in Midterm Follow-up. OBES SURG 27, 1098–1103 (2017). https://doi.org/10.1007/s11695-017-2610-0

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  • DOI: https://doi.org/10.1007/s11695-017-2610-0

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