Success of the Band- Article by a doctor
Lap band weight loss surgery has been performed internationally since its introduction in the mid 1990s and, in many countries, it has now become very much the preferred method of weight loss surgery. It was not however licensed for use in the United States until June 2001 and it is only now that sufficient statistics are becoming available to allow us to assess just how good a treatment it is for those seeking a solution to morbid obesity.
At this early stage the lap band success rate is looking pretty good, which is excellent news for the 15 million Americans who are now classed as being severely obese. Weight loss achieved using lap band surgery compares favorably with other forms of surgery and there are also fewer complications, both during and after surgery, with those complications that do occur proving less serious than in other forms of weight loss surgery. Lap band success is also being seen in the terms of the reduction of associated (co-morbid) conditions such as type 2 diabetes, sleep apnea and hypertension.
On average patients are spending less time in hospital with an overnight stay for lap band surgery compared to a stay of 2 to 3 days for laparoscopic Roux-en-Y surgery and 3 to 4 days for the open Roux-en-Y procedure. In addition, recovery time is much improved with lap band patients resuming their normal activities within about a week compared to 2 to 3 weeks for Roux-en-Y patients.
As a purely restrictive form of surgery, early post-operative weight loss for lap band patients is less dramatic than that seen in open or laparoscopic Roux-en-Y patients but is nonetheless still impressive with patients achieving similar weight loss in the longer term.
In one early study involving 271 US patients undergoing lap band surgery the average weight loss achieved 3 years after surgery was 47% of excess body weight, while a second US study of 63 patients showed an excess weight loss of 53%. Several studies involving larger groups of patients from both Italy and Australia over a similar 3 year period show excess weigh loss ranging from 49% to as high as 68%.
In most cases of weight loss surgery attention tends to be focused on weight loss when assessing just how successful a procedure is and it is easy to think that an operation which produces a 50% weight loss must be more successful than one that produces a 45% weight loss. In reality of course both can be equally successful as the true question is whether or not patients lose sufficient weight to meet their expectations and see an overall improvement in their general health, life expectancy and quality of life. Lap band success therefore needs to be measured in terms of the overall package of benefits that it delivers to its patients.
Of all the surgical options available today lap band surgery is the least invasive and involves the shortest period of hospitalization and fastest recovery. It is also the only adjustable form of surgery currently available and is the easiest form of surgery to reverse. Perhaps most importantly, it avoids many of the problems associated with stomach stapling and re-routing of the intestinal tract which makes it very much safer than other forms of weight loss surgery.
It is still early days of course and time will tell but, if early lap band success is anything to go by, it would seem safe to say that lap band weight loss surgery is set to follow the pattern seen internationally and it may well soon become the preferred option in the United States.
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