Introduction:
There is an increasing use of revision surgery following primary laparoscopic adjustable gastric band (LAGB) placement. The safety of laparoscopic single-stage revision (LSSR) compared to 2-stage revision is of interest to healthcare providers, patients and economists.
Objectives:
To review early (within 30 days) and late (> 30 day) complications of our consecutive LSSR cases from LAGB to sleeve gastrectomy (LSSR-SG) and one anastomosis gastric bypass (LSSR-OAGB).
Methods:
Retrospective analysis of our prospectively maintained database from November 2013 to May 2017.
Results:
We identified 131 patients who had LSSR surgery. The majority, 81.7%, of patients were female. Eighty-three patients underwent LSSR-SG (mean age 44.0 +/- 1.2 years, weight 108.4 +/- 2.9 kg and BMI 39.3 +/- 1.0 kg/m2) and 48 patients had LSSR-OAGB (mean age 44.4 +/- 1.5 years, weight 133.7 kg +/- 4.2, BMI 48.2 +/- 1.3 kg/m2).
Three patients re-presented with early complications: 1 following LSSR-SG, left portal venous thrombosis; and 2 following LSSR-OAGB; functional bowel obstruction (n = 1) and abdominal pain (n = 1). There were 2 late complications, both following LSSR-OAGB; small bowel obstruction (n = 1) and worsening renal function due to high oxalate absorption (n = 1). There were no leaks or deaths following LSSR-SG or LSSR-OAGB.
Conclusion:
None of the complications were thought directly related to the single-stage nature of the surgery. We believe both LSSR-SG and LSSR-OAGB are safe procedures that ameliorate the additional risks and costs associated with second stage surgery following LAGB.