Abstract
Background
Transoral gastroplasty (TOGA) has been offered as an investigational alternative restrictive procedure in our hospital for the last 3 years. Since laparoscopic Roux-en-Y gastric bypass (LRYGBP) can be performed as a revisional surgery after failure of a restrictive surgery, this study reports on the feasibility of conversion of TOGA into a LRYGBP in case of failure of the endoscopic procedure.
Methods
Since 2006, 71 TOGA procedures were performed in morbidly obese patients. Four patients underwent an LRYGBP after TOGA procedure for unsatisfactory results after 1-year observation. All of them had undergone a second procedure in which additional TOGA restrictions were placed to attempt to tighten the pouch before being referred for LRYGBP. The surgical outcome of these patients was analysed.
Results
All four patients were easily converted to a LRYGBP with no major complication and no mortality. The operative results (operating time, morbidities, follow-up) of all LRYGBP post TOGA were similar to primary LRYGBP performed by the same operator.
Conclusion
LRYGBP post-TOGA apparently can be done without any trouble. The performance of TOGA does not seem to interfere with the short-term results of the LRYGBP.
References
Deviere J, Ojeda Valdes G, Cuevas Herrera L, et al. Safety, feasibility and weight loss after transoral gastroplasty (TOGa™): first human multicenter study. Surg Endosc. 2008;22:589–98.
Moreno C, Closset J, Dugardeyn S, et al. Transoral gastroplasty is safe, feasible and induces significant weight loss in morbidly obese patients: results of the second human pilot study. Endoscopy. 2008;40:406–13.
Olbers T, Lönroth H, Fagevik-Olsen M, et al. Laparoscopic gastric bypass: development of technique, respiratory function, and long-term outcome. Obes Surg. 2003;13:364–70.
Gonzalez R, Gallagher SF, Haines K, et al. Operative technique for converting a failed vertical banded gastroplasty to Roux-en-Y gastric bypass. J Am Coll Surg. 2005;201:366–74.
Mognol P, Chosidow D, Marmuse JP. Roux-en-Y gastric bypass after failed vertical banded gastroplasty. Obes Surg. 2007;17:1431–4.
Gumbs A, Pomp A, Gagner M. Revisional bariatric surgery for inadequate weigh loss. Obes Surg. 2007;17:1137–45.
Iannelli A, Amato D, Addeo P, et al. Laparoscopic conversion of vertical banded gastroplasty (Mason, MacLean) into Roux-en-Y gastric bypass. Obes Surg. 2008;18:43–6.
Ikramuddin S, Kellogg TA, Lselie DB. Laparoscopic conversion of vertical banded gastroplasty to a Roux-en-Y gastric bypass. Surg Endosc. 2007;21:1927–30.
Schouten R, Van Dielen F, Van Gemert W, et al. Conversion of vertical banded gastroplasty to Roux-en-Y gastric bypass results in restauration of the positive effect of weight loss and co-morbidities: evaluation of 101 patients. Obes Surg. 2007;17:622–30.
Sanchez H, Cabrera A, Cabrera K, et al. Laparoscopic roux-en-Y gastric bypass as a revision procedure after restrictive bariatric surgery. Obes Surg. 2008;18:1539–43.
Yang O, Loi K, Liew V, et al. Staged laparoscopic sleeve gastrectomy followed by Roux-en-Y gastric bypass for morbidly obese patients: a risk reduction strategy. Obes Surg. 2008;18:1575–80.
Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Closset, J., Germanova, D., Loi, P. et al. Laparoscopic Gastric Bypass as a Revision Procedure After Transoral Gastroplasty. OBES SURG 21, 1–4 (2011). https://doi.org/10.1007/s11695-009-0036-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-009-0036-z