From band to bypass: A technical perspective

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C Rajkumar Vinayak, J Q L Low, H Leslie, B K See and R Umasangar

Taiping Hospital, Malaysia

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Abstract

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Due to its common complications and high failure rates, Laparoscopic Adjustable Gastric Bands (LAGB) are commonly associated with re-do procedures. Conventional revisional options include Roux-en-Y gastric bypass (LRYGB) and Sleeve Gastrectomies (SG) which are on the other hand, technically more demanding and are associated with higher risk of leaks and complications compared to primary operations. It is still being debated if these revisional procedures should be done in the same setting versus a two-step approach or whether a RYGB should be favored over SG or vice versa. Other options include conversion to gastric plication and duodenal switch which are possibly equally effective but all come with a significant requirement of technicalities. Studies have shown that both LRYGB and SG are both feasible and effective options after LAGB with good results. At our center we performed 201 bariatric interventions during 2015-16. Twenty two (22) revisional procedures were performed of which 5 was gastric band related revisions. One of the patients had gastric band erosion where we had to intervene twice laparoscopically, once for removal of band plus drainage and subsequently she underwent a conversion to a RYGB. She was eventually discharged well. All other patients were discharged uneventfully and well on further follow up. The presentation today aims to highlight revisional key steps of a simple but potentially catastrophic procedure.

Biography

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C Rajkumar Vinayak is a Consultant General and Bariatric Surgeon at General Hospital Taiping, Malaysia. He has completed his MBBS from JIPMER, India in 1996 and MS (General Surgery) from Osmania University, India in 2002. He has achieved his FIAGES and then went on to complete his Fellowship in Advanced Laparoscopy and Bariatric Surgery from L.O.C. Pune, India. He has been performing bariatric surgeries in Northern Malaysia since 2007 and became the 1st Surgeon from Malaysia and ASEAN region to be designated as Surgeon of Excellence on Metabolic and Bariatric Surgery by Surgical Review Corporation (SOEMBS), USA in 2017.

Email: rajkumarvnyk@yahoo.com