Banded sleeve gastrectomy provides better weight loss than non-banded sleeve gastrectomy: Study

As a primary bariatric procedure, SG leads to excellent weight loss, yet weight regain is a relevant issue in mid- to long-term follow-up. Retrospective analyses suggest that banding a sleeve using a silicone ring may decrease weight regain and improve weight loss.

Laparoscopic sleeve gastrectomy (SG) is the most performed bariatric/metabolic operation. However, inadequate long-term weight loss remains a problem in some cases, possibly from gastric-sleeve dilation. Adding a reinforcing ring around the proximal gastric sleeve has been proposed, but relevant data are scant.

Therefore, Jodok M Fink and associates from the Department of General and Visceral Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany conducted the present study to compare silicone-banded sleeve gastrectomy (BSG) to non-banded sleeve gastrectomy (SG) regarding weight loss, obesity-related comorbidities, and complications.

The authors conducted the banded versus nonbanded sleeve gastrectomy single center, randomized controlled trial on 94 patients, where they defined the primary endpoint as excess weight loss 3 years after surgery. However, secondary endpoints included the surgery's impact on obesity-related comorbidities, quality of life, and complications.

Among 94 patients randomized, 97% completed 3-year follow-up. Mean initial body mass index was 50.9 kg/m.

The authors observed the following results-

2. Mean adjusted excess weight loss 3 years after SG amounted to 62.3% and 73.9% after BSG.
3. Remission of type 2 diabetes occurred in 66.7% after SG and in 91.0% following BSG.
4. Three years after surgery, ring implantation correlated with decreased frequency of symptomatic reflux episodes but increased frequency of regurgitation.
5. The rate of major complications was not different between the study groups.
6. Quality of life was better following BSG.

Hence, "BSG provided better weight loss than non-banded SG 3 years after surgery. Regurgitation was the main clinically relevant negative effect after BSG", they concluded.