Our Summary

This research paper is a review of past studies on two types of weight-loss surgeries: laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG), both performed after an initial procedure called laparoscopic adjustable gastric banding (LAGB) did not work as intended. The authors looked at eight studies involving 635 patients to compare the outcomes of the two surgeries. They found that both types of surgeries had similar rates of complications, required similar lengths of hospital stays, and resulted in similar amounts of weight loss at 6 and 12 months. However, patients who underwent the LRYGB procedure had greater weight loss and a larger reduction in their body mass index (BMI) 24 months after surgery. The authors suggest that more randomized studies are needed to better understand the outcomes of these two types of revision surgeries.

FAQs

  1. What are the clinical outcomes of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy in obese patients following failed laparoscopic adjustable gastric banding?
  2. How do the complications, conversions, mean hospital stay, and weight loss compare between the LRYGB and LSG procedures?
  3. Are there any randomized controlled studies comparing the outcomes of revisional LRYGB and LSG?

Doctor’s Tip

One helpful tip a doctor might tell a patient about gastrectomy is to follow a strict post-operative diet and exercise plan to support successful weight loss and recovery. It is important to listen to your doctor’s recommendations, attend follow-up appointments, and communicate any concerns or changes in symptoms. Additionally, make sure to stay hydrated, take prescribed medications as directed, and gradually introduce solid foods back into your diet as advised by your healthcare provider.

Suitable For

Patients who are typically recommended gastrectomy are those who have failed previous weight loss interventions such as laparoscopic adjustable gastric banding (LAGB) and are obese. In particular, obese patients who have experienced complications or inadequate weight loss after LAGB may be good candidates for laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) as a revisional procedure. These patients may benefit from the improved weight loss outcomes and potential resolution of comorbidities associated with these procedures.

Timeline

Before Gastrectomy:

  • Patient undergoes failed laparoscopic adjustable gastric banding (LAGB) procedure
  • Patient experiences complications or lack of desired weight loss with LAGB
  • Patient consults with healthcare provider about options for revisional surgery
  • Patient and healthcare provider discuss risks and benefits of laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG)

After Gastrectomy:

  • Patient undergoes laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) procedure
  • Patient may experience complications such as infection, bleeding, or leakage in the immediate post-operative period
  • Patient is monitored in the hospital for a few days before being discharged
  • Patient follows a strict diet and exercise regimen to aid in weight loss and recovery
  • Patient attends follow-up appointments with healthcare provider to monitor progress and address any concerns
  • Patient may experience significant weight loss and improvements in overall health and quality of life over time.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with gastrectomy surgery?
  2. How does gastrectomy compare to other weight loss procedures in terms of effectiveness and long-term outcomes?
  3. What is the recovery process like after gastrectomy surgery?
  4. Will I need to make any lifestyle changes, such as dietary restrictions or increased physical activity, after the surgery?
  5. How often will I need follow-up appointments after the surgery?
  6. What can I expect in terms of weight loss and improvement in my overall health after gastrectomy?
  7. Are there any specific vitamins or supplements I should be taking after gastrectomy surgery?
  8. How will gastrectomy surgery affect my ability to absorb nutrients from food?
  9. What is the expected impact of gastrectomy on existing health conditions such as diabetes or high blood pressure?
  10. Are there any support groups or resources available for patients who have undergone gastrectomy surgery?

Reference

Authors: Magouliotis DE, Tasiopoulou VS, Svokos AA, Svokos KA, Sioka E, Zacharoulis D. Journal: Obes Surg. 2017 May;27(5):1365-1373. doi: 10.1007/s11695-017-2644-3. PMID: 28303508