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Comparative Study
. 2003 Jan;237(1):10-6.
doi: 10.1097/00000658-200301000-00002.

Surgical treatment of severe obesity with a low-pressure adjustable gastric band: experimental data and clinical results in 625 patients

Wim Ceelen  1 , Jean Walder, Anne Cardon, Katrien Van Renterghem, Uwe Hesse, Mohamed El Malt, Piet Pattyn
Affiliations
Comparative Study

Surgical treatment of severe obesity with a low-pressure adjustable gastric band: experimental data and clinical results in 625 patients

Wim Ceelen et al. Ann Surg. 2003 Jan.

Abstract

Objective: To evaluate the use of a low-pressure gastric band in the treatment of severe obesity in a prospective study.

Summary background data: Gastric banding for severe obesity has been associated with erosion and perforation of the stomach. The Swedish adjustable gastric band (SAGB) has been proposed as a low-pressure device.

Methods: From January 1998 to October 2001, 625 patients underwent laparoscopic SAGB. Median age was 36 years, and 80.4% of patients were female. Median preoperative body mass index (BMI) was 40. Previous upper abdominal surgery was reported in 36 (6%) patients. A five-trocar technique was used without a calibration balloon.

Results: Median follow-up was 19.5 months. All patients were treated laparoscopically with a median operating time of 80 minutes. Conversion was necessary in two patients (0.3%): one trocar injury of the mesentery and one esophageal perforation. Median hospital stay was 3 days; there were no 30-day deaths. Early morbidity was present in 27 patients (4.3%). Late band reoperation was necessary in 49 patients (7.8%). Indications for reoperation were band slippage or pouch dilation, acute total dysphagia, and band leakage or malfunction. Median excess weight loss was 45.8%, 49.9%, and 47.4% after 1, 2, and 3 years, respectively, with a measurable beneficial effect on arterial hypertension, sleep apnea syndrome, and diabetes control.

Conclusions: SAGB is a safe and effective new method in the management of severe obesity. Long-term follow-up (>3 years) is necessary to confirm its effectiveness and safety.

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Figures

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Figure 1. Pressure–volume curves of two gastric banding models (two data sets). SAGB, Swedish adjustable gastric band.
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Figure 2. Percentage of excess weight loss (EWL) over 36 months. Bars represent mean (standard deviation).
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Figure 3. Evolution of postoperative body mass index (BMI) over a 36-month period. Bars represent mean (standard deviation).
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Figure 4. Effect of reoperation on excess weight loss evolution. Bars represent mean (standard deviation).
See this image and copyright information in PMC

Comment on

  • Gastric banding.
    Kellum JM. Kellum JM. Ann Surg. 2003 Jan;237(1):17-8. doi: 10.1097/00000658-200301000-00003. Ann Surg. 2003. PMID: 12496525 Free PMC article. No abstract available.

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