Laparoscopic adjustable gastric banding (LAGB) is one of the most frequently performed types of weight loss surgery. This surgical treatment for obesity, which involves implanting a medical device to control eating, has been gaining in popularity ever since it became available, largely due to its apparent safety and simplicity compared to the gastric bypass procedures.
Although short term results have been considered successful with LAGB, the procedure is still relatively new. Until now, the outcomes of patients over time has been basically unknown.
In a recently published study, we can finally take a look at data for long term results and complications of Swedish adjustable gastric banding. The study is the work of researchers who are reporting their 10 years of experience with patients of the Swedish adjustable gastric band (SAGB).
Since there are few long term studies currently available, the results of this new study will provide some very helpful insights into the importance of patient selection and expected weight loss results.
The study evaluated patients who had SAGB surgery from 1996 to 2006. Out of 785 procedures, follow up data were available for 733 patients.
Researchers arrived at two primary conclusions: the SAGB is an effective bariatric procedure for achieving weight loss and patient selection according to specific criteria is necessary due to the high complication and reoperation rate.
Among the findings:
- The median excess weight loss (EWL) after 8 years was 65.5%
- The median BMI decreased from 42.9 to 28.3
- A total of 688 complications occurred in 396 patients (50.4%)
- There was no mortality
The most common complications reported in the study were:
- esophagitis (28.8%)
- pouch dilation (15.3%)
- esophageal dilation (12.5%)
- port problems (11%)
- band migration (6.5%)
- band leakage (6.4%)
- reoperations (32%)
LAGB has been performed outside the US since the mid 1990’s. Currently, there are two bands which have received FDA approval for use in the United States. The LAP-BAND was approved in 2001. The SAGB, which is marketed in the United States as the REALIZE Band, was approved in 2007.
For many years, Roux-en-Y gastric bypass surgery has been considered the gold standard for bariatric procedures, having nearly forty years of experience to back it up. Without long term data available for LAGB, it has not been known how LAGB would measure up to gastric bypass over time. It seems that the results hold up just fine.
Source: “Results and Complications after Swedish Adjustable Gastric Banding—10 Years Experience”, Reinhard P. Mittermair, Sabine Obermüller, Alexander Perathoner, Michael Sieb and Franz Aigner, et al., Obesity Surgery, 2009, Volume 19, Number 12, Pages 1636-1641