[Reintervention for failed vertical banded gastroplasty: the adjustable lapband offers a useful technique to further restrict a restrictive procedure].

Background: Reintervention for failed bariatric procedures is a subject of much debate. Our experience in remediating failed vertical banded gastroplasty (VBG) suggests that the placement of an adjustable lapband may be a useful technique.
Patients and Methods: Over a 13-year period, 98 patients with failed VBG underwent remedial placement of an adjustable lapband. Unsatisfactory results of VBG were due to disruption of the staple line in 58% of cases and to outlet enlargement in 37% of patients. Mean BMI was 38 (range: 28-48); BMI was less than 35 in 37% of cases.
Results: Seven postoperative complications (7%) were noted and required the removal of the lapband in five cases. The average loss of excess weight was 52% at 8 years. Twenty-two percent of patients were lost to follow-up.
Conclusion: Placement of an adjustable lapband has proved to be a useful remedial approach in the majority of cases and demonstrates that further restriction of a previous restrictive procedure is useful in patients who initially responded well to VBG.