Surgery

Biography

Biography: Mohammed Ghunaim

Abstract

Introduction: Gastro-gastric fi xation (GGF) during laparoscopic adjustable gastric banding (LAGB) is of great debate while the result of large retrospectives studies showed no increase of slippage rate and easier band removal in case of conversion to another procedure when the band has not been coated, nowadays data are still inadequate to conclude that GGF should be abandoned. Objectives: Th e aim of the study was to show the non-inferiority of LAGB with out GGF. Th e main criteria was the comparison of the reoperation rate at 1 and 3 years. Methods: ANOSEAN study is a controlled prospective randomized single-blind trial (CPP). Seventeen bariatric centers included a total of 706 patients (calculated with power=.8, alpha=.05 and reoperation rate: 24%, delta: 8%). Patients in group 1 received gastric banding with GGF while group 2 with out GGT. Results: Follow-up at 1 year was 89.8%. At baseline, patients were similar regarding sex, age and BMI. GGF increased operative time (43±28 mn vs. 39±25 mn; p<0.001). One early slippage (Day 2) occurred in group 2. At 1 year, reoperation rate in group 1 was 1.5% vs. 4.3% in group 2 (p=0.039). Considering only reoperation for slippage, band removal or repositioning rate was higher in the non-fi xation group at 1 year (2.9% vs. 0%, p=0.002). In multivariate analysis, non-fixation was an independent risk factor of reoperation and slippage (OR:3.2 (95% CI: 1.2-9.1), p<0.001). Conclusion: Preliminary results at 1 year showed that GGF prevents band slippage and reoperation. Benefits of no fixation have to be assessed during band removal and redo surgery to conclude definitely whether surgeon should continue to do GGF.