Laparoscopic adjustable gastric banding with truncal vagotomy versus laparoscopic adjustable gastric banding alone: interim results of a prospective randomized trial

Abstract

Background: In an attempt to potentiate the effect of laparoscopic gastric banding (LGB) on weight reduction and to reduce the risk of weight regain, we added laparoscopic truncal vagotomy (TV) to adjustable LGB. We report on our early interim results of a prospective 5-year randomized clinical trial comparing patients who underwent LGB plus TV (LGBTV) with a control group who underwent LGB alone.

Methods: From December 2005 to November 2006, patients were randomly allocated to LGBTV or LGB alone. In the LGBTV group, the anterior and posterior vagus trunks were isolated and resected after preparing and encircling the esophagus at the diaphragmatic crus. In both groups, an 11-cm Lap-Band System was positioned by way of the pars flaccida.

Results: A total of 50 patients were entered into the study. No mortality resulted, and no conversion to laparotomy was needed. Neither group had any intra- or postoperative complications. The mean weight, body mass index, and percentage of excess weight loss were not significantly different statistically between the 2 groups at 12 or 18 months after surgery (P = NS). At 6 months of follow-up, band adjustment was not required in 10 (50%) of 20 patients with LGBTV compared with 5 (20%) of 25 patients with LGB alone (P = .034). At 12 months, 7 (35%) of 20 LGBTV patients and 2 (8%) of 25 LGB patients still did not require band adjustment (P = .024).

Conclusion: The results of our study have shown that adding TV to LGB does not cause specific morbidity or mortality compared with LGB alone. During the first postoperative year, the addition of TV to LGB decreased the number of patients requiring band adjustments.