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    • Banded Versus Non-Banded Sleeve Gastrectomy “Comparative Study”

    Elsobky A, MD
    Department of General Surgery– Ain Shams University

    Background Laparoscopic sleeve gastrectomy, as a primary operation in the management of morbid obesity, was first reported in 2003, documented as single therapy in the treatment of morbid obesity. With increasing experience, a number of complications have been reported with SG including dilatation of the remaining stomach. Also, doubts still persist regarding long-term weight loss. The placement of a band or gastric ring around the upper sleeve will further limit the volume of food intake and prevent dilatation of the gastric sleeve distal to the band in the long term. The procedure thus combines the potential benefits of SG and gastric banding. Methods: One hundred thirty-nine obese patients were enrolled in this study between (Feb ruary 2014) to (September 2016) in Safwat Elgolf private hospital. They were divided into two groups, group (1) with banded laparoscopic sleeve gastrectomy BLSG (42 patients 30%) and group (2) with non-banded laparoscopic sleeve gastrectomy NLSG (97 patients 70%). We analyzed differences in post-operative excess weight loss, operative time, as well as complication rate between the two groups through 3 years follow up. Results: Early follow-up (first 3 months) showed insignificant excess weight loss difference in both groups. However the difference become significant starting from 6 months postoperatively and continues to the end of 3years follow up. At 6 months the %EWL was 59.2 ± 17.8 for BLSG and 47.2 ± 15 for LSG (P value < 0.001), at 12 months the %EWL 63.8 ± 16 for BLSG and 60.6 ± 21.8 for LSG( P value < 0.001), At 24 months the %EWL was 70.6 ± 17.4 for BLSG and 63.2 ± 23 for NLSG ( P value < 0.001) and at 36 months the %EWL was 80.4 ± 13.3for BLSG and 59.3 ± 24.2for NLSG( P value < 0.001). No statistical difference between the two groups as regards operative time. Conclusion: BLSG surgery was found to be safe, feasible and effective; it gives better 1, 2 and 3-year weight loss results than NLG. However. Complication rates are significantly higher in the BLSG than that for NSG, mainly in band related complications, e.g.; stenosis, vomiting and esophageal reflux, but these complications are late and minor. The time required for the device positioning did not influence significantly the surgical time. Further studies will need to be conducted to compare if the weight loss curve converge by 5 years. Keywords: Sleeve gastrectomy, banded sleeve gastrectomy, bariatric surgery, obesity, body mass index.

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