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Laparoscopic gastric banding

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Introduction: Laparoscopic gastric banding (LGB) is currently the most popular purely restrictive bariatric operation in Europe and many other countries. It has a low operative morbidity, but is associated with a substantial late complication rate. Many late complications have been attributed to technical errors or to the learning curve. The aim of this paper is to present our results with gastric banding after the learning curve in order to disclose the true incidence of long-term complications. Methods: LGB was introduced in our department in December 1995. Thirty patients were operated on until June 1997 using the early banding technique (band within the lesser sac), at which time the surgical technique was slightly modified in order to place the band above the lesser sac. Then another 300 patients underwent LGB using either the Lapband or the SAGB system. This report focuses on the latter patients. All the data were collected prospectively. Results: The series includes 300 patients (257 women and 43 men) with a mean age of 38.3 years (19–64). The mean initial weight was 119.2 kg (57–179), initial body mass index (BMI) was 43.3 kg/m2 (21–64), and initial excess weight was 96.5% (0–191). The mean duration of surgery was 90 min, decreasing over time to a mean of 75 min for the last 50 cases. Early overall morbidity was 6.6%. Major complications occurred in 7 patients (2.3%). Excess weight loss (EWL) was at least 50% in 66% of the patients after 2 years, averaging 60%, with no substantial change until 4 years, and the BMI stabilized between 30 and 31 kg/m2. Forty-nine patients developed a total of 52 long-term complications, of which 23 (7.6%) were related only to the port or catheter. Band erosion occurred in 17 (5.6%), pouch dilatation with slippage in 8 (2.6%), and infection in 4 (1.3%) patients. Fifty-five reoperations were necessary. Twenty-five of these were related only to the port. The band was removed from 26 (9%) patients, of whom 17 were converted to Roux-en-Y gastric bypass. Conclusions: LGB gives satisfactory results in terms of weight loss in about two-thirds of the patients. Even beyond the learning curve, the long-term morbidity is not negligible, but is acceptable compared to other procedures such as vertical banded gastroplasty. Conversion to gastric bypass is possible when complications occur and can be performed when the band is removed in most cases.

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  1. 1

    JS Azagra M Goergen J Ansay P De Simone M Vanhaverbeek L Devuyst J Squelaert (1999) ArticleTitleLaparoscopic gastric reduction surgery. Preliminary results of a randomized, prospective trial of laparoscopic vs open vertical banded gastroplasty. Surg Endosc 13 555–558 Occurrence Handle10.1007/s004649901039 Occurrence Handle1:STN:280:DyaK1M3nvVGgtw%3D%3D Occurrence Handle10347289

  2. 2

    M Belachew M Legrand V Vincent M Lismonde N LeDocte V Deschamps (1998) ArticleTitleLaparoscopic adjustable gastric banding. World J Surg 22 955–963 Occurrence Handle1:STN:280:DyaK1czotlWnuw%3D%3D

  3. 3

    GB Cadière J Bruyns J Himpens F Favretti (1994) ArticleTitleLaparoscopic gastroplasty for morbid obesity. Br J Surg 81 1524 Occurrence Handle7820493

  4. 4

    JM Calmes V Bettschart W Raffoul M Suter (2002) ArticleTitleBand infection with splenoportal venous thrombosis: an unusual but severe complication of gastric banding. Obes Surg 12 699–702 Occurrence Handle10.1381/096089202321019729 Occurrence Handle1:STN:280:DC%2BD38nosFWktA%3D%3D Occurrence Handle12448396

  5. 5

    E Chelala GB Cadière F Favretti J Himpens M Vertruyen J Bruyns L Maroquin M Lise (1997) ArticleTitleConversions and complications in 185 laparoscopic adjustable silicone gastric banding cases. Surg Endosc 11 268–271 Occurrence Handle10.1007/s004649900341 Occurrence Handle1:STN:280:ByiB3snntlE%3D Occurrence Handle9079607

  6. 6

    InstitutionalAuthorNameConsensus Development Conference Panel (1991) ArticleTitleGastrointestinal surgery for severe obesity: consensus development conference statement. Ann Intern Med 115 956–961

  7. 7

    InstitutionalAuthorNameConsensus Development Conference Panel (1999) ArticleTitleConsensus sur le traitement de l’obésité en Suisse Schweiz Med Wochenschr 129 IssueIDsuppl 114 4S–20S

  8. 8

    J Dargent (1999) ArticleTitleLaparoscopic adjustable gastric banding: lessons from the first 500 patients in a single institution. Obes Surg 9 446–452 Occurrence Handle10.1381/096089299765552729 Occurrence Handle1:STN:280:DC%2BD3c%2FntF2itQ%3D%3D Occurrence Handle10605901

  9. 9

    . De Maria HJ Sugerman JG Meador JM Doty JM Kellum L Wolfe RA Szucs MA Turner (2001) ArticleTitleHigh failure rate after laparoscopic adjustable silicone gastric banding for treatment of morbid obesity. Ann Surg 233 809–818 Occurrence Handle10.1097/00000658-200106000-00011 Occurrence Handle1:STN:280:DC%2BD3M3nslGktg%3D%3D Occurrence Handle11371739

  10. 10

    F Favretti GB Cadière G Segato J Himpens L Busetto F De Marchi M Vertruyten G Enzi M De Luca M Lise (1997) ArticleTitleLaparoscopic adjustable silicone gastric banding (Lap-Band): How to avoid complications Obes Surg 7 352–358 Occurrence Handle10.1381/096089297765555610 Occurrence Handle1:STN:280:DyaK1czpvVaqsw%3D%3D Occurrence Handle9730523

  11. 11

    GA Fielding M Rhodes LK Nathanson (1999) ArticleTitleLaparoscopic gastric banding for morbid obesity. Surgical outcome in 335 cases. Surg Endosc 13 550–554 Occurrence Handle10.1007/s004649901038 Occurrence Handle1:STN:280:DyaK1M3nvVGgtg%3D%3D Occurrence Handle10347288

  12. 12

    P Forsell B Hallerback H Glise G Hellers (1999) ArticleTitleComplications following Swedish adjustable gastric banding: a long-term follow-up. Obes Surg 9 11–16 Occurrence Handle1:STN:280:DyaK1M7mtlCmtQ%3D%3D Occurrence Handle10065574

  13. 13

    P Forsell G Heller (1997) ArticleTitleThe Swedish adjustable gastric banding (SAGB) for morbid obesity: 9-year experience and a 4-year follow-up of patients operated with a new adjustable band. Obes Surg 7 345–351 Occurrence Handle10.1381/096089297765555601 Occurrence Handle1:STN:280:DyaK1czpvVaqsg%3D%3D Occurrence Handle9730522

  14. 14

    KD Higa KB Boone H Teinchin OG Davies (2000) ArticleTitleLaparoscopic Roux-en-Y gastric bypass for morbid obesity. Technique and preliminary results of our first 400 patients. Arch Surg 135 1029–1034 Occurrence Handle1:STN:280:DC%2BD3cvmtF2luw%3D%3D

  15. 15

    C Klaiber A Metzger P Forsell (2000) ArticleTitleLaparoskopisches gastric banding. Chirurgie 71 146–151 Occurrence Handle1:STN:280:DC%2BD3c7pvVOmtQ%3D%3D

  16. 16

    U Kunath M Susewind S Klein T Hofmann (1998) ArticleTitleErfolg und Misserfolg beim laparoskopischen “Gastric Banding”. Chirurgie 69 180–185 Occurrence Handle1:STN:280:DyaK1c3ht1KhtA%3D%3D

  17. 17

    K Miller E Hell (1999) ArticleTitleLaparoscopic adjustable gastric banding: a prospective 4-year follow-up study. Obes Surg 9 183–187 Occurrence Handle10.1381/096089299765553467 Occurrence Handle1:STN:280:DyaK1M3ntVKjsg%3D%3D Occurrence Handle10340775

  18. 18

    H Nehoda H Weiss B Labeck K Hourmont M Lanthaler M Oberwalder F Aigner (2001) ArticleTitleResults and complications after adjustable gastric banding in a series of 250 patients. Am J Surg 181 12–15 Occurrence Handle1:STN:280:DC%2BD3Mvit1Sntg%3D%3D Occurrence Handle11248168

  19. 19

    TN Nguyen C Goldman J Rosenquist A Arango CJ Cole SJ Lee BM Wolfe (2001) ArticleTitleLaparoscopic verus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg 234 279–291 Occurrence Handle10.1097/00000658-200109000-00002 Occurrence Handle1:STN:280:DC%2BD3MvotVymtA%3D%3D Occurrence Handle11524581

  20. 20

    PE O’Brien WA Brown Smith PJ McMurrick (1999) ArticleTitleProspective study of a laparoscopically placed adjustable gastric band in the treatment of morbid obesity. Br J Surg 85 113–118 Occurrence Handle10.1046/j.1365-2168.1999.00964.x

  21. 21

    HE Oria MK Moorehead (1998) ArticleTitleBariatric analysis and reporting outcome system. Obes Surg 8 487–499 Occurrence Handle10.1381/096089298765554043 Occurrence Handle1:STN:280:DyaK1M%2FjsVerug%3D%3D Occurrence Handle9819079

  22. 22

    WJ Pories MS Swanson KJ MacDonald SB Long PG Morris BM Brown HA Barakat RA deRamon G Israel JM Dolezal L Dohm (1995) ArticleTitleWho would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 222 339–352 Occurrence Handle1:STN:280:ByqH3cjps1I%3D Occurrence Handle7677463

  23. 23

    RB Reinhold (1982) ArticleTitleCritical analysis of long-term weight loss following gastric bypass. Surg Gynecol Obstet 155 385–394 Occurrence Handle1:STN:280:Bi2B2sjnvVY%3D Occurrence Handle7051382

  24. 24

    G Silecchia A Restuccia U Elmore D Polito N Perrotta A Genco V Bacci N Basso (2001) ArticleTitleLaparoscopic adjustable silicone gastric banding. Prospective evaluation of intragastric migration of the Lap-band. Surg Laparosc Endosc 11 229–234 Occurrence Handle1:STN:280:DC%2BD3Mvot1Cisg%3D%3D

  25. 25

    R Stieger M Thurnheer J Lange (1998) ArticleTitleMorbide Obesitas: Ergebnisse des “laparoscopic gastric banding” bei 130 konsekutiven Patienten. Schweiz Med Wochenschr 128 1239–1246 Occurrence Handle1:STN:280:DyaK1cvjtVSmtw%3D%3D Occurrence Handle9757489

  26. 26

    M Suter (2001) ArticleTitleLaparoscopic band repositioning for pouch dilatation/slippage after gastric banding: disappointing results. Obes Surg 11 507–512 Occurrence Handle10.1381/096089201321209431 Occurrence Handle1:STN:280:DC%2BD3MvlsFehsg%3D%3D Occurrence Handle11501365

  27. 27

    M Suter V Bettschart V Giusti E Heraief A Jayet (2000) ArticleTitleA 3-year experience with laparoscopic gastric banding for obesity. Surg Endosc 14 532–536 Occurrence Handle10.1007/s004640000114 Occurrence Handle1:STN:280:DC%2BD3cvitlWnsQ%3D%3D Occurrence Handle10890959

  28. 28

    M Suter C Jayet A Jayet (2000) ArticleTitleVertical banded gastroplasty. Long-term results comparing three different techniques. Obes Surg 10 41–46 Occurrence Handle10.1381/09608920060674094 Occurrence Handle1:STN:280:DC%2BD3c7ptVyrtA%3D%3D Occurrence Handle10715643

  29. 29

    J Urban K Garvin (2001) ArticleTitleInfection after total hip arthroplasty. Curr Opin Othop 12 64–70 Occurrence Handle10.1097/00001433-200102000-00013

  30. 30

    R Weiner D Wagner H Bockhorn (1999) ArticleTitleLaparoscopic gastric banding for morbid obesity. J Laparoendosc Adv Surg Tech 9 23–30

  31. 31

    A Westling K Bjurling M Ohrvall S Gustavsson (1998) ArticleTitleSilicone-adjustable gastric banding: disappointing results. Obes Surg 8 467–474 Occurrence Handle10.1381/096089298765554386 Occurrence Handle1:STN:280:DyaK1cvgtVCisg%3D%3D Occurrence Handle9731684

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Suter, M., Giusti, V., Héraief, E. et al. Laparoscopic gastric banding . Surg Endosc 17, 1418–1425 (2003).

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  • Gastric banding
  • Morbid obesity
  • Laparoscopy