There is a wide discrepancy of outcomes for patients who have decided to have weight loss surgery and are experiencing different weight loss, regain and complications primary related to their choice of the procedure. In our practice we see quite a few revisions cases on weekly basis. More recently there have been a few “Rebanding” patients seeking revision to the Duodenal Switch.
The typical scenario is of a patient who had an adjustable gastric band placed, and after the initial weight loss (mostly because of the persistent nausea and vomiting) the weight stabilized. The weight loss was never close to a healthy weight and in most cases their co-morbidities did not resolve but now have added complications of reflux and abdominal pain developed. These patients were then recommended to have the band repositioned to resolve a slipped band causing the above complications.
The scientific evidence for rebranding is not justifiable. I think there continues to be an element of denial that the adjustable gastric banding procedures do not work for the vast majority of the people. In fact, AGB in the long term will result in some complications that may not be revisable. The scientific literature shows that there is no benefit to rebranding when it comes to weight loss.
In my opinion when a patient encounters problem with the adjustable gastric band, Duodenal Switch operation represent the best option because it has the best long term outcome of all weight loss surgical procedures.