Tamer M Saeid Salama*, Mohamed Lasheen, Mohamed Fayek
Introduction: In the last decade some endoscopic bariatric maneuvers i.e. intragastric balloons, gastroplasty techniques, aspiration therapy, and gastrointestinal bypass sleeves intragastric balloon appear as safe efficient less invasive tool for the treatment of obesity.
However due to the high incidence of weight regain unsatisfactory weight loss after IGB, or its associated complications i.e. GERD, gastric ulcers, and balloon migration, the need for bariatric surgery are increased after IGB.
In this study, we are aiming to evaluate the surgical outcome of LSG In comparison to SASI after failed IGB as regard BMI changes and postoperative complications.
Patients and Methods: Forty patients (25 females and 15 males) complaining from weight regain or unsatisfactory weight loss after IGB with a mean age of 28.2 years and an average BMI of 45.7 kg/m2 were enrolled in this study.
Results: One year after the operation, there was a significant difference between both procedures in weight loss in which the postoperative mean BMI of cases converted into SASI (26.3 kg/m2) and that of cases converted into sleeve gastrectomy (31.4 kg/m2), this difference can be explained by the malabsorptive power of SASI. After SASI no leakage occurred and only one case suffered from reflux. On the other hand, there was one case of leakage and one case of reflux occurred after LSG.
Conclusion: IGB is a foreign body inside the stomach, it makes marked adhesion between the stomach and pancreas. Its restrictive nature increases the incidence of postoperative complications and poor weight loss if followed by LSG, on the other hand, SASI is a safe and feasible bariatric surgery after the failed balloon. It can achieve early weight loss with minimal post-operative complications.