Banded And Sleeved..... Anyone?

[waygook 0]

So my doctor does this surgery where bandsters keep their band and he sleeves them as well.

He believes this is a great idea because though sleevers get their stomach cut, just like a bandsters pouch, over time sleevers can stretch their sleeve over time and so having the band as a back up for fills to make more restrcition should help with weight loss in the long long run.

I know some new banded sleevers, and have heard of 5+ year banded sleevers but was just wondering if anyone on here has this situation and how it is going?

[Shellyac 22]

Here is a study that did something similar,

Banded sleeve gastrectomy--initial experience.

Alexander JW, Martin Hawver LR, Goodman HR.

Source

Center for Surgical Weight Loss, Department of Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, USA. jwesley.alexander@uc.edu

Abstract

BACKGROUND:

Isolated sleeve gastrectomy is being used with increasing frequency for the treatment of morbid obesity. This study was done to determine the potential benefit of placing a band of processed human dermis around the upper portion of a sleeve gastrectomy to prevent late dilatation and weight gain.

METHODS:

Twenty-seven patients underwent a sleeve gastrectomy followed by placement of a band of biological tissue (AlloDerm) placed 6 cm from the gastroesophageal junction. The results were compared to 54 patients with a Roux-en-Y gastric bypass (GBP), matched for sex, age, and initial body mass index.

RESULTS:

All 27 patients had improvement or resolution of their diabetes, hypertension, hyperlipidemia, and sleep apnea after banded sleeve gastrectomy (BSG) similar to the control GBP group. There were no deaths, but one patient had a pulmonary embolus and another had a presumed leak. Symptoms of gastroesophageal reflux disease generally improved. Overall, results were almost identical to patients with GBP.

CONCLUSIONS:

BSG provides results comparable to GBP in the short-term follow-up, but avoids potential long-term complications including internal hernias, postoperative bowel obstructions, anastomotic complications of the jejunojejunostomy, hypoglycemia, bacterial overgrowth, and a spectrum of malabsorptive problems. While this study documents the feasibility and possible benefits of this modification, prospective controlled studies with long-term follow-up are needed to establish its place in procedures for surgical weight loss.

[Shellyac 22]

And here is another paper but it looks like it was only based on one case.

Laparoscopic adjustable banded sleeve gastrectomy as a primary procedure for the super-super obese (body mass index > 60 kg/m2).

Agrawal S, Van Dessel E, Akin F, Van Cauwenberge S, Dillemans B.

Source

Department of Bariatric Surgery, Homerton University Hospital, London, UK. sanju_agrawal@hotmail.com

Abstract

Isolated laparoscopic sleeve gastrectomy is increasingly being used for the treatment of morbid obesity. However, doubts still persist regarding long-term weight loss, and the 5-year results are awaited. Whether the aetiology of failed excess weight loss is the result of an inadequate sleeve or attributable to dilatation of the sleeve is not clear. In an effort to prevent gastric dilatation and increase gastric restriction to promote further weight loss in the long term, we performed a combined procedure of laparoscopic adjustable gastric banding with sleeve gastrectomy. The patient was a 39-year-old woman with a life-long history of obesity and a body mass index of 79.8 kg/m(2). The surgical technique of the laparoscopic adjustable gastric banded sleeve gastrectomy is described. There were no immediate complications, and the patient was discharged home on the third postoperative day. She is doing extremely well on clinic follow-up at 6 weeks. To the best of our knowledge, laparoscopic adjustable gastric banded sleeve gastrectomy, as a primary operation, has not been described in the literature. It is hoped that this combined procedure will be most useful in the super-super obese (body mass index > 60) patients. More patients with a long-term follow-up are necessary to provide definitive conclusions regarding long-term benefits and complications of this combined bariatric procedure.

[kemo46 82]

I have talked to several surgeons about this topic. A very large percentage of their surgeries are band TO sleeve revisions. The surgeons I talked with do not like to leave the band in if they will be performing a sleeve. The main reason that they gave was even after a successful VSG, the remaining band could errode,slip or just plain fail. They preferred to remove the band if performing the VSG to guard against any future complications.

A few of the surgeons I spoke would only do the sleeve plication in liew of the VSG if the band was to remain inside the patient but they also agreed, it was best and safer for the patient to have the old band removed.

I understand the above studies is a type of procedure with both used, I am speaking of band to sleeve revisions. When doing my research, I found the sleeve to be superior to the band as long as it was a viable medical option.

[MoonSiren 48]

I don't know why you'd need the band. I can barely eat even half of a kid's meal. Do people stretch their sleeves out that bad? I never heard of this option.

[Shellyac 22]

I think it is more of a precaution and it is similar to what they are doing with the banded plication. In theory all you should need is just plication but for some people they lose restriction for whatever reason. I am also surprised to see it done in conjunction with the regular sleeve especially since I haven't seen many studies that many people with the sleeve have stretched out that much that they render the sleeve ineffective (I've seen a few posts about needed to be resleeved). The only logic of doing a band at the start is that you only want to do surgery once so put the back up plan in place from the beginning.