Laparoscopic adjustable gastric band remains a safe, effective, and durable option for surgical weight loss

Abstract

Background: Despite many patients doing well after laparoscopic adjustable gastric band (LAGB) several studies caution offering this procedure for weight loss. The aim of our study was to review our long-term results over a decade.

Methods: Following IRB approval, the Metabolic and Bariatric Surgery Quality Improvement Program (MBSAQIP) Data Registry was used to identify LAGB placement between 2007 and 2013 by a single surgeon. We sought to determine complications of initial operation, weight loss and resolution of comorbidities over time, the indications for reoperation including removal, revision or conversion to another weight loss surgery. Chi-square test was used to analysis.

Results: From 403 LAGB performed between January 2007 and December 2013, 75 patients required reoperation with total 79 procedures, including band revision and/or conversion. Mean follow-up time was 5.78 years (73.67 months). The rate of reoperation was at least 18.61%. There were 60 band removals, 10 band revisions, 9 conversions to either sleeve or gastric bypass. Only 16 patients (20.25%) required reoperation due to inadequate weight loss. Band slippage/prolapse remained the most common non weight-related indication for reoperation (23, 29.11%). Reoperation associated with longer length of stay compared to index procedures (2.12 days vs 1.63 days, p < 0.0001) but no statistical difference in 30_days_complication. Of those who did not require reoperation, BMI at 10th year follow-up was 37.50 from initial BMI of 42.23 with EWL of 39.22%.

Conclusions: Lap band is effective for most patients with long-term durability. Over time approximately one fifth will need additional surgery. Only one fifth of reoperation relates to inadequate weight loss.

Keywords: Bariatric surgery; Conversion; Laparoscopic assisted gastric band; Long-term outcomes; Revision.