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Obesity, Bariatric and Metabolic Surgery pp 327–332Cite as

LAGB: Current Controversies

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Abstract

Laparoscopic adjustable gastric banding (LAGB) is a safe and effective option for weight loss surgery, but is still subject to controversies. This chapter aims to address some of these issues.

Surgical technique is as yet not standardized. This chapter discusses the current opinions regarding gastric band placement and fixation, hiatal hernia repair and port fixation. The newer technique of single incision laparoscopic surgery (SILS) is also covered.

The decision regarding which weight loss procedure best suits each patient should be made on an individual basis. This chapter discusses what factors should be taken into consideration for different patient groups including adolescents, the elderly, those with binge eating disorder (BED), the pregnant patient, and those undergoing revisional surgery.

LAGB has lower perioperative risks than other surgical options and long-term follow up is essential to optimize results. Gastric banding remains an important method of weight loss surgery but the finer details of the procedure continue to stimulate controversy. In future, well designed studies will help to improve outcomes.

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References

  1. O’Brien PE, Dixon JB, Laurie C, Anderson M. A prospective randomized trial of placement of the laparoscopic adjustable gastric band: comparison of the perigastric and pars flaccida pathways. Obes Surg. 2005;15(6):820–6.

    Article  PubMed  Google Scholar 

  2. Di Lorenzo N, Furbetta F, Favretti F, Segato G, De Luca M, Micheletto G, et al. Laparoscopic adjustable gastric banding via pars flaccida versus perigastric positioning: technique, complications, and results in 2,549 patients. Surg Endosc. 2010;24(7):1519–23.

    Article  PubMed  Google Scholar 

  3. Suter M, Dorta G, Giusti V, Calmes JM. Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients. Obes Surg. 2004;14(7):959–66.

    Article  CAS  PubMed  Google Scholar 

  4. Dixon JB, Cobourn CS. Exploration of esophageal hiatus: does crural repair reduce proximal pouch distension? Surg Obes Relat Dis. 2013;9(3):350–5.

    Article  PubMed  Google Scholar 

  5. Gulkarov I, Wetterau M, Ren CJ, Fielding GA. Hiatal hernia repair at the initial laparoscopic adjustable gastric band operation reduces the need for reoperation. Surg Endosc. 2008;22(4):1035–41.

    Article  PubMed  Google Scholar 

  6. Azagury DE, Varban O, Tavakkolizadeh A, Robinson MK, Vernon AH, Lautz DB. Does laparoscopic gastric banding create hiatus hernias? Surg Obes Relat Dis. 2013;9(1):48–52.

    Article  PubMed  Google Scholar 

  7. Burton PR, Brown WA, Laurie C, Korin A, Yap K, Richards M, et al. Pathophysiology of laparoscopic adjustable gastric bands: analysis and classification using high resolution video manometry and a stress barium protocol. Obes Surg. 2010;20(1):19–29.

    Article  PubMed  Google Scholar 

  8. Brown WA, Burton PR, Anderson M, Korin A, Dixon JB, Hebbard G, et al. Symmetrical pouch dilatation after laparoscopic adjustable gastric banding: incidence and management. Obes Surg. 2008;18(9):1104–8.

    Article  PubMed  Google Scholar 

  9. Humphreys LM, Meredith H, Morgan J, Norton S. Detection of asymptomatic adenocarcinoma at endoscopy prior to gastric banding justifies routine endoscopy. Obes Surg. 2012;22(4):594–6.

    Article  PubMed  Google Scholar 

  10. Lazzati A, Polliand C, Porta M, Torcivia A, Paolino LA, Champault G, Barrat C. Is fixation during gastric banding necessary? A randomised clinical study. Obes Surg. 2011;21(12):1859–63.

    Article  CAS  PubMed  Google Scholar 

  11. Avsar FM, Sakcak I, Yildiz BD, Cosgun E, Hamamci EO. Is gastro-gastric fixation suture necessary in laparoscopic adjustable gastric banding? A prospective randomized study. J Laparoendosc Adv Surg Tech A. 2011;21(10):953–6.

    Article  PubMed  Google Scholar 

  12. Singhal R, Kitchen M, Ndirika S, Hunt K, Bridgwater S, Super P. The “Birmingham stitch”-avoiding slippage in laparoscopic gastric banding. Obes Surg. 2008;18(4):359–63.

    Article  PubMed  Google Scholar 

  13. VanWageningen B, Aarts EO, Janssen IM, Berends FJ. Access-port fixation on the left pectoral fascia in laparoscopic adjustable gastric band. Obes Surg. 2011;21(3):386–90.

    Article  Google Scholar 

  14. Clough A, Layani L, Sidhu M, Wheatley L, Shah A. Subfascial port placement in gastric band surgery. Obes Surg. 2011;21(5):604–8.

    Article  PubMed  Google Scholar 

  15. Arvind N, Bates SE, Morgan JD, Hewin DF, Frering VM, Norton SA. Fixation of the access-port is not required in gastric banding. Obes Surg. 2007;17(5):577–80.

    Article  PubMed  Google Scholar 

  16. Ayloo SM, Fernandes E, Masrur MA, Giulianotti PC. Adjustable gastric banding: a comparison of models. Surg Obes Relat Dis. 2014;10(6):1097–103. pii: S1550–7289(13)00298–0.

    Article  PubMed  Google Scholar 

  17. Devienne M, Caiazzo R, Chevallier J-M, Himpens J, Verhelst H, Pattou F, et al. Comparison of the laparoscopic implantation of an adjustable BIORING gastric ring versus the VANGUARD: randomized prospective study. Obésité. 2013;8(2):63–8.

    Article  Google Scholar 

  18. Patel AG, Murgatryd B, Ashton WD. Single Incision laparoscopic adjustable gastric banding: 111 cases. Surg Obes Relat Dis. 2012;8(6):747–51.

    Article  PubMed  Google Scholar 

  19. O’Brien PE, MacDonald L, Anderson M, Brennan L, Brown WA. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg. 2013;257(1):87–94.

    Article  PubMed  Google Scholar 

  20. Black JA, White B, Viner RM, Simmons RK. Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis. Obes Rev. 2013;14(8):634–44.

    Article  CAS  PubMed  Google Scholar 

  21. Busetto L, Angrisani L, Basso N, Favretti F, Furbetta F, Lorenzo M. Safety and efficacy of laparoscopic adjustable gastric banding in the elderly. Obesity (Silver Spring). 2008;16(2):334–8.

    Article  Google Scholar 

  22. Wadden TA, Faulconbridge LF, Jones-Corneille LR, Sarwer DB, Fabricatore AN, Thomas JG, et al. Binge eating disorder and the outcome of bariatric surgery at one year: a prospective, observational study. Obesity (Silver Spring). 2011;19(6):1220–8.

    Article  PubMed Central  Google Scholar 

  23. Weiss HG, Nehoda H, Labeck B, Hourmont K, Marth C, Aigner F. Pregnancies after adjustable gastric banding. Obes Surg. 2001;11(3):303–6.

    Article  CAS  PubMed  Google Scholar 

  24. Dixon JB, Dixon ME, O’Brien PE. Pregnancy after lap-band surgery: management of the band to achieve healthy weight outcomes. Obes Surg. 2001;11(1):59–65.

    Article  CAS  PubMed  Google Scholar 

  25. Jefferys AE, Siassakos D, Draycott T, Akande VA, Fox R. Deflation of the gastric band balloon in pregnancy for improving outcomes. Cochrane Database Syst Rev. 2013;30(4):CD010048.

    Google Scholar 

  26. Rogers CA, Welbourn R, Byrne J, Donovan JL, Reeves BC, Wordsworth S, et al. The by-band study: gastric bypass or adjustable gastric band surgery to treat morbid obesity: study protocol for a multi-centre randomised controlled trial with an internal pilot phase. Trials. 2014;15(1):53.

    Article  PubMed Central  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Bariatric Surgery, Surrey & Sussex Healthcare NHS Trust, Musgrove Park Hospital, Taunton, UK

    Simon J. W. Monkhouse MA, MBBChir, FRCS

  2. Department of Surgery, North Bristol NHS Trust, Southmead Hospital, Bristol, UK

    Sally A. Norton MB ChB, MD, FRCS

Authors
  1. Simon J. W. Monkhouse MA, MBBChir, FRCS
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  2. Sally A. Norton MB ChB, MD, FRCS
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Corresponding author

Correspondence to Sally A. Norton MB ChB, MD, FRCS .

Editor information

Editors and Affiliations

  1. Homerton University Hospital, London, United Kingdom

    Sanjay Agrawal

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© 2016 Springer International Publishing Switzerland

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Monkhouse, S.J.W., Norton, S.A. (2016). LAGB: Current Controversies. In: Agrawal, S. (eds) Obesity, Bariatric and Metabolic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-04343-2_33

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  • DOI: https://doi.org/10.1007/978-3-319-04343-2_33

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-04342-5

  • Online ISBN: 978-3-319-04343-2

  • eBook Packages: MedicineMedicine (R0)

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