Lap-Band Outcomes & Results

Journal of Laparoendoscopic & Advanced Surgical Techniques Lap-Band^®: Outcomes and Results

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To cite this paper:
Paul E. O'Brien, John B. Dixon. Journal of Laparoendoscopic & Advanced Surgical Techniques. August 1, 2003, 13(4): 265-270. doi:10.1089/109264203322333593.

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Full Text PDF: • HiRes for printing (843.9 KB) • PDF Plus w/ links (740.4 KB)

Paul E. O'Brien, MD, FRACS Monash University Department of Surgery, The Alfred Hospital, Melbourne, Victoria, Australia. John B. Dixon, MBBS, PhD, FRACGP Monash University Department of Surgery, The Alfred Hospital, Melbourne, Victoria, Australia.

Introduction: Laparoscopic adjustable gastric banding was first introduced in the early 1990s as a potentially safe, controllable, and reversible method for achieving significant weight loss in the severely obese. The Bioenterics Lap-Band® system (Inamed Health, Santa Barbara, California) is the device most commonly used. After 10 years of experience in treating more than 100,000 patients with the Lap-Band, it is timely for us to review the outcomes.

Methods: Data for the review are derived from the experience of our unit in the treatment of 1250 patients to date, from an independent systematic review of the published literature up to September 2001, and from major studies published after the date of closure of the systematic review.

Results: Lap-Band placement has proved to be a very safe procedure with a mortality rate in the published reports of 1 in 2000, only 10% of the published mortality rate of gastric bypass. The early complication rate has been very low, but late complications of prolapse or erosions have been more frequent, particularly during the early experience.

Weight is lost during the first 2 to 3 years after surgery. The systematic review reports 56% excess weight loss (EWL) at 5 years (three reports). In comparison, Roux-en-Y gastric bypass (RYGB) is reported to have achieved 59% EWL at 5 years (four reports).

Major improvements in comorbid conditions have been reported in association with weight loss after Lap-Band placement. Most importantly, type 2 diabetes is usually cured, and insulin resistance and reduced pancreatic β-cell function are reversed. Gastroesophageal reflux, obstructive sleep apnea, and depression are other diseases in which marked improvement is noted. Quality-of-life scores return to normal values.

Conclusions: Lap-Band placement is proving to be safe and effective. In view of the attributes of adjustability, safe laparoscopic placement, and reversibility, it should be considered the optimal initial approach for the control of obesity and its comorbid conditions.

Thanks for posting this Charline,

Very informative, very uplifting.  I think overall, for me, it just confirms and and validates my decision to do what I hoped and considered to be the safest way to lose my excess weight and to ensure a healthy lifestyle.

I think its more common now for surgeons to refer to a 15 year study I believe it is - I tried to find the link but dont see it bookmarked - anyway a 15 year study on RNY and the results show 60-70 % of excess body weight is lost.

This is what I was told - was 60-70% - with his experience with patients being closer to the 70%.

I am happy because I have now lost over 65% of my excess weight and I am only on month 7.

So I am gonna keep on truckin!

I think that you have to do your research- tons of it , talk to post ops and be happy with your surgeon and his experience and record and then make an informed decision which surgery is right for you..... then to me personally the  rest of it is in gods hands.

Many blessings and Happy losing ! 

deb

Dr B refers to a study that shows for people with a BMI of less than 60, the band is as effective as RNY.

FYI- The function of the pancreatic β-cell is the storage and release of insulin, the main hormone involved in blood glucose homeostasis.