Randomized Comparative study between laparoscopic sleeve gastrectomy and Laparoscopic banded sleeve gastrectomy

Abstract

Laparoscopic sleeve gastrectomy (LSG) is the bariatric procedure with the fastest growing numbers worldwide, and today is the second mostoften conducted bariatric operation, exceeded only by Roux-en Y gastric bypass (RYGB). In 2011, almost 95,000 procedures were completed worldwide (Buchwald et al.,2013). The original indication for LSG was primarily to reduce operative risk in the super obese, now it is widely accepted as a stand-alone procedure . Furthermore, early and mid-term weight-loss and resolution of comorbidities is equal to RYGB( Rosenthal et al.,2012). Sleeve dilatation with subsequent consumption of larger meals is a drawback for this purely restrictive procedure and can be responsible for insufficient weight loss (Deguines et al.,2013). The suspicion that sleeve dilatation correlates with weight gain led our group to measure sleeves with three-dimensional computed tomography (CT) in selected patients. Unfortunately, a thoracic sleeve migration was found in approximately 40 % of examined cases. Furthermore, stomach volume analysis surprisingly revealed that migrated sleeves were smaller than formally correctly positioned sleeves (Baumann et al.,2011). Based on this knowledge , we proposed this a randomized comparative study between conventional LSG and a banded laparoscopic sleeve gastrectomy (BLSG) using a prolene mesh . BLSG was first performed in June 2007 using a polyurethane (GaBP) ring Summary & conclusion (Karcz et al , 2007). Others initiated a similar technique wrapping the sleeve stomach with a piece of AlloDerm® (Alexander et al , 2009). In this study there was no significant statistical difference between both groups as regard the intra operative complication and early post operative one year follow up however, there was minimal increase in vomiting in group who underwent BLSG. This study documents the feasibility and possible benefits of BLSG. Prospective controlled studies with long-term follow-up are needed to establish laparoscopic banded Sleeve Gastrectomy in bariatric procedures for surgical long term weight loss.