Journal
OBESITY SURGERY
Volume 11, Issue 6, Pages 752-756Publisher
F D-COMMUNICATIONS INC
DOI: 10.1381/09608920160558722
Keywords
morbid obesity; bariatric surgery; gastric restriction; re-operation; vertical gastroplasty; gastric banding; biliopancreatic diversion
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Background: Since 1988 we performed gastric restriction operations on 890 patients; 60 required subsequent re-operation. Methods: The Molina non-adjustable band was discontinued early because of a high percentage of reoperations. Between 1992 and 1995, we performed the Mason vertical banded gastroplasty (VBG) using a 9-cm long vertical staple-line, with a re-operation rate of 15%. Since 1996, we have been performing a 6-cm long vertical staple-line, with a re-operation rate of 0.7%. The MacLean VBG also had a low reoperation rate (0.9%), but the seriousness of its most dangerous complication, perioperative cardia fistula, limited our use of this method to specifically selected cases. With adjustable banding, we have used the Swedish band which produced a low reoperation rate (2.1%), consisting of relatively simple corrective procedures. Results: The re-operations produced results similar to those of first-time operations In terms of weight loss and nutritional status. In particular, after 3 years, re-operated patients had similar weight to those who had been operated upon with the same method initially. Conclusions: When the surgical procedure was selected with greater astuteness and modified appropriately, the re-operation rate decreased from 17% in the period 1992 to 1995, to 1% in the period 1996 to 2000.
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