Source
Medicosurgical Department of Gastroenterology, Erasmus Hospital, Free University of Brussels, Route de Lennik 808, 1070 Brussels, Belgium. jean.closset@erasme.ulb.ac.be
Abstract
BACKGROUND:
Transoral gastroplasty (TOGA) has been offered as an investigational alternative restrictive procedure in our hospital for the last 3 years. Since laparoscopic Roux-en-Y gastric bypass (LRYGBP) can be performed as a revisional surgery after failure of a restrictive surgery, this study reports on the feasibility of conversion of TOGA into a LRYGBP in case of failure of the endoscopic procedure.
METHODS:
Since 2006, 71 TOGA procedures were performed in morbidly obese patients. Four patients underwent an LRYGBP after TOGA procedure for unsatisfactory results after 1-year observation. All of them had undergone a second procedure in which additional TOGA restrictions were placed to attempt to tighten the pouch before being referred for LRYGBP. The surgical outcome of these patients was analysed.
RESULTS:
All four patients were easily converted to a LRYGBP with no major complication and no mortality. The operative results (operating time, morbidities, follow-up) of all LRYGBP post TOGA were similar to primary LRYGBP performed by the same operator.
CONCLUSION:
LRYGBP post-TOGA apparently can be done without any trouble. The performance of TOGA does not seem to interfere with the short-term results of the LRYGBP.