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Journal of Obesity
Volume 2013 (2013), Article ID 108507, 4 pages
http://dx.doi.org/10.1155/2013/108507
Clinical Study

Endoscopic Revision (StomaphyX) versus Formal Surgical Revision (Gastric Bypass) for Failed Vertical Band Gastroplasty

1Department of Surgery, University of Alberta, Edmonton, AB, Canada T6G 2B7
2Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
3Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada T6G 2B7
4Center for the Advancement of Minimally Invasive Surgery (CAMIS), Community Services Center, Royal Alexandra Hospital, Room 405, 10240 Kingsway, Edmonton, AB, Canada T5H 3V9

Received 30 September 2012; Revised 4 December 2012; Accepted 18 December 2012

Academic Editor: Francesco Saverio Papadia

Copyright © 2013 Johan Bolton et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Weight regain secondary to VBG pouch dilation is a typical referral for Bariatric surgeons. In this study we compare an endoluminal pouch reduction (Stomaphyx) to RYGB for revision. Methods. A retrospective review was completed for patients with a previous VBG presenting with weight regain between 2003–2010. Results. Thirty patients were identified for study 23 RYGB, 14 StomaphyX. Significant post procedure BMI loss was seen in each cohort (RYGB,  kg/m2 to  kg/m2; StomaphyX  kg/m2 to  kg/m2, ). Whereas nausea and headache were the only complications observed in StomaphyX patients, the RYGB group had a 43.5% complication rate and 1 mortality. Complications following RYGB include: incisional hernia (13%), anastomotic leak (8.7%), respiratory failure (8.7%), fistula (8.7%), and perforation (4.35%). The median length of stay following RYGB was 6 days compared to days following StomaphyX. Conclusion. This study suggests that while RYGB revision may achieve greater weight loss, the complication rates and severity is discouraging. StomaphyX may be a safe alternative. Further technical modifications of the device and longer follow-up may clarify the role of this approach.