How Is a Gastric Band to Gastric Sleeve Conversion Surgery Done?

Gastric band surgery, a method that has been performed for nearly twenty years but is associated with low effectiveness and high complication rates, has significantly declined after the widespread adoption of sleeve gastrectomy. However, since it was once very commonly performed, a large number of revision surgeries are now being carried out.

Why Did Gastric Band Surgery Fail?

Gastric banding is a procedure in which a clamp is placed around the fundus of the stomach and connected to a device positioned under the abdominal skin, allowing it to be inflated. This restricts food intake and makes eating more difficult.

The main issue lies in the fact that the hunger hormone (ghrelin) is not removed. As a result, the patient continues to feel hungry. Even though food passage through the stomach is restricted, the ongoing appetite makes it difficult for patients to control their eating habits, often leading to weight regain.

How Is Gastric Band to Gastric Sleeve Conversion Surgery Performed?

• The first step, as in all bariatric surgeries, is to perform an endoscopic evaluation beforehand.
• Like most obesity surgeries, this procedure is performed laparoscopically (closed technique).
• The initial step is the removal of the gastric band.
• In approximately 20% of cases, the band may migrate into the stomach (migration).
• In such cases, the band must be removed endoscopically, and surgery should be delayed for at least three months afterward.
• If there is no migration, the band is removed laparoscopically.
• If no reflux is detected during endoscopy, sleeve gastrectomy can be performed in the same session.

How Is Conversion to Gastric Bypass Performed?

For patients who have previously undergone gastric band surgery and experienced weight regain, gastric bypass may be a more suitable option, especially if reflux is present.