Primary silicone-banded laparoscopic sleeve gastrectomy: a pilot study

Abstract

Introduction: Some degree of inadequate weight loss or recidivism is seen with all bariatric surgical approaches. To combat this, some authors have suggested placing a reinforcing ring around gastric bypass pouches or gastric sleeves. The aim of this study was to assess the initial feasibility and efficacy of silicone-banded laparoscopic sleeve gastrectomy (LSG).

Materials and methods: All cases of silicone-banded LSG performed at our center were retrospectively identified. Patient demographics, perioperative parameters, and postoperative outcomes were extracted and analyzed.

Results: Thirteen patients (7 females, 6 males) were identified and analyzed. Preoperatively, patients had a mean age of 56.0 ± 8.3 years, a mean body mass index (BMI) of 53.7 ± 8.5 kg/m(2), and a median of seven comorbidities. All cases were completed laparoscopically by one surgeon, with a mean operative time of 140.7 ± 25.7 minutes and a mean estimated blood loss of 56.9 ± 30.6 mL. There were no mortalities. The only intraoperative complication was a respiratory arrest after extubation, and this patient recovered fully. Postoperatively, 2 patients (15.4%) experienced a complication: one had a pulmonary embolism requiring brief re-admission, and the other had a syncopal episode from a second-degree atrioventricular block. No long-term complications were encountered. One patient was lost to follow-up. At a median follow-up of 16 months (range, 6-27 months), the mean BMI of the cohort was 38.7 ± 7.9 kg/m(2), which corresponded to a mean excess weight loss (EWL) of 54.8 ± 19.6%.

Conclusions: This report provides initial evidence that silicone-banded LSG is feasible and can be performed with minimal morbidity and significant EWL at short-term follow-up.