Talk at the Royal Australasian College of Surgeons Meeting in Brisbane by: Ahmed Rahman, Amjid Riaz, William Hawkins and Michael Talbot
Revision Bariatric surgery is technically demanding and associated with high morbidity rates due to formation of adhesions and distortion of proximal gastric anatomy. The aim of current study was to assess whether the application of an adhesion barrier film onto the operative field after the removal of the gastric band had any impact on the number and amount of adhesions at the time of the revision surgery after failed gastric banding.
Method: A pilot study with 19 patients having band removal, followed by sleeve gastrectomy 3 months later was performed between 2013–2015. The patients were randomised to either a Control group (11 patients) who received band removal only or the Active Group (8 patients) who had a sprayable adhesion barrier applied at the time of band removal. The second procedures for both groups were independently graded for adhesions. All procedures were recorded and were assessed in a blind fashion as to the severity of adhesions (grade 1–5).
Results: The total adhesion score for the control group (n=11) was 32 (mean 2.82). The active group (n=8) has a total adhesion score of 12 (mean 1.5). Statistical adhesion scoring P=0.05. The average operative time for the control group was 73 minutes and 56 minutes for the active group (P= NS).
Conclusion: In our pilot study an adhesion barrier leads to a statistical significant reduction in adhesion formation and operative time. This warrants consideration of a larger trial to assess whether adhesion barriers may reduce morbidity in reoperative bariatric surgery.
0 Comments