ASMBS: Gastric Banding Gets Low Marks

1.Visscher TLS, Seidell JC. The public health impact of obesity. Annu Rev Publ Health 2001; 22: 355-375.
2.Mokdad A, Bowman B, Ford E, et al. The continuing epidemics of obesity and diabetes in the United States. JAMA 2001; 286: 1195-1200.
3.Allen JW, Coleman MG, Fielding GA. Lessons learned from laparoscopic gastric banding for morbid obesity. Am J Surg 2001; 182: 10-14.
4.O'Brien PE, Brown WA, Smith A, et al. Prospective study of a laparoscopically placed, adjustable gastric band in the treatment of morbid obesity. Br J Surg 1999; 86: 113-118.
5.DeMaria EJ, Sugarman HJ, Meador JG, et al. High failure rate after laparoscopic adjustable silicone gastric banding for treatment of morbid obesity. Ann Surg 2001; 233: 809-818.
6.Holeczy P, Novak P, Kralova A. 30% complications with adjustable gastric banding: what did we do wrong? Obes Surg 2001; 11: 748-751.
7.Forsell P, Hallberg D, Hellers G. Gastric banding for morbid obesity: initial experience with a new adjustable band. Obes Surg 1993; 3: 369-374.
8.Wright TA, Kow L, Wilson T, et al. Early results of laparoscopic Swedish adjustable gastric banding for morbid obesity. Br J Surg 2000; 87: 362.
9.Hesse UJ, Berrevoet F, Ceelen W, et al. Adjustable silicone gastric banding and the Swedish adjustable gastric banding in treatment of morbid obesity. Chirurgie 2001; 72: 14-18.
10.Berrevoet F, Pattyn P, Cardon A, et al. Retrospective analysis of laparoscopic gastric banding technique: short-term and mid-term follow-up. Obes Surg 1999; 9: 272-275.
11.Cardon A, Berrevoet F, Pattyn P, et al. Alternative technique for creation of a proximal gastric pouch in laparoscopic adjustable silicone gastric banding. Obes Surg 1999; 9: 410-412.
12.Klaiber C, Metzger A, Forsell P. Laparoscopic gastric banding. Chirurgie 2000; 71: 146-151.
13.Gastrointestinal Surgery for Severe Obesity. NIH Consensus Development Conference Consensus Statement 1991; 9:25-27.
14.Kushner R. Managing the obese patient after bariatric surgery: a case report of severe malnutrition and review of the literature. JPEN 2000; 24: 126-132.
15.International Bariatric Surgery Registry. IBSR 2000-2001 Winter Pooled Report, 2001. International Bariatric Surgery Registry, Iowa City. Available at: http://www.asbs.org. Accessed May 7, 2002.
16.de Wit LT, Mathus-Vliegen L, Hey C, et al. Open versus laparoscopic adjustable silicone gastric banding. A prospective randomized trial for treatment of morbid obesity. Ann Surg 1999; 230: 800-807.
17.de Jonge ICDYM, Tan KG, Oostenbroek RJ. Adjustable silicone gastric banding: A series with three cases of band erosion. Obes Surg 2000; 10: 26-32.
18.Dixon JB, O'Brien PE. Health outcomes of severely obese type 2 diabetic subjects 1 year after laparoscopic adjustable gastric banding. Diabetes Care 2002; 25: 358-363.
19.Smith SC, Goodman GN, Edwards CB. Roux-en-Y gastric bypass. A retrospective review of 3855 patients. Obesity Surg 1995; 5: 314-318.

Omg Mom u are a wealth of info! (Note to bandster.............these studies are called medical research..........NOT "band bashing"!!!).

Can J Surg. 2009 Dec ;52 (6):E249-58 20011160 Cit:3 Five-year outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in a comprehensive bariatric surgery program in Canada.
[My paper] Nicolas Christou, Evangelos Efthimiou
Section of Bariatric Surgery, Division of General Surgery, McGill University Health Centre, Montréal, Que. [email protected]
BACKGROUND: Bariatric surgery remains the most effective modality to induce sustainable weight loss in the morbidly obese. Our aim was to compare outcomes between the laparoscopic Roux-en-Y gastric bypass (LRYGBP) and the laparoscopic adjustable gastric banding device (LAGBD) method with 5-year follow-up in a Canadian bariatric surgery centre. METHODS: This is a retrospective outcomes analysis of 1035 laparoscopic bariatric procedures performed over 7 years. We extracted data from our prospectively collected bariatric surgery registry from Feb. 1, 2002, to Jun. 30, 2008. We evaluated patient demographics, weight loss, complications, mortality and need for revision surgery by procedure type. RESULTS: We examined outcomes in 149 (14.4%) LAGBD and 886 (85.6%) LRYGBP procedures. The mean body mass index (BMI) was significantly higher in the LRYGBP group (50.9, standard deviation [SD] 8.9, v. 45.0, SD 6.7) whereas age and sex ratio were the same. There were 3 deaths (0.3%) in the LRYGBP group and no deaths in the LAGBD group. Sixteen patients (10.8%) in the LAGBD group needed conversion to LRYGBP because of poor weight loss, band intolerance, band erosion or slippage, and 6 patients (0.7%) in the LRYGBP group required revision because of inability to achieve the desired weight loss. The percent excess-weight loss was 41, 49, 59, 60 and 61 at 1, 2, 3, 4 and 5 years postsurgery for the LAGBD patients who kept their band, and 70, 79, 79, 79 and 75 for the LRYGBP patients. CONCLUSION: Laparoscopic weight loss surgery can be performed safely with acceptable mortality. Our study suggests superior weight loss and low revision requirement for the LRYGBP, making this a more durable procedure in a publicly funded health care system.
Keywords: lrygbp; laparoscopic; bariatric; gastric; bariatric surgery; gastric band; gastric bypass; adjustable gastric; laparoscopic roux-en-y; laparoscopic adjustable; weight loss; roux-en-y gastric; band; roux-en-y; surgery;

Surg Obes Relat Dis. 2007 Feb 26;: 17331805 Cit:35

Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 5-year results of prospective randomized trial.
Luigi Angrisani, Michele Lorenzo, Vincenzo Borrelli
S. Giovanni Bosco Hospital, Naples, Italy.
BACKGROUND: To perform a prospective, randomized comparison of laparoscopic adjustable gastric banding (LAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS: LAGB, using the pars flaccida technique, and standard LRYGB were performed. From January 2000 to November 2000, 51 patients (mean age 34.0 +/- 8.9 years, range 20-49) were randomly allocated to undergo either LAGB (n = 27, 5 men and 22 women, mean age 33.3 years, mean weight 120 kg, mean body mass index [BMI] 43.4 kg/m(2); percentage of excess weight loss 83.8%) or LRYGB (n = 24, 4 men and 20 women, mean age 34.7, mean weight 120 kg, mean BMI 43.8 kg/m(2), percentage of excess weight loss 83.3). Data on the operative time, complications, reoperations with hospital stay, weight, BMI, percentage of excess weight loss, and co-morbidities were collected yearly. Failure was considered a BMI of >35 at 5 years postoperatively. The data were analyzed using Student's t test and Fisher's exact test, with P <.05 considered significant. RESULTS: The mean operative time was 60 +/- 20 minutes for the LAGB group and 220 +/- 100 minutes for the LRYGB group (P <.001). One patient in the LAGB group was lost to follow-up. No patient died. Conversion to laparotomy was performed in 1 (4.2%) of 24 LRYGB patients because of a posterior leak of the gastrojejunal anastomosis. Reoperations were required in 4 (15.2%) of 26 LAGB patients, 2 because of gastric pouch dilation and 2 because of unsatisfactory weight loss. One of these patients required conversion to biliopancreatic diversion; the remaining 3 patients were on the waiting list for LRYGB. Reoperations were required in 3 (12.5%) of the 24 LRYGB patients, and each was because of a potentially lethal complication. No LAGB patient required reoperation because of an early complication. Of the 27 LAGB patients, 3 had hypertension and 1 had sleep apnea. Of the 24 LRYGB patients, 2 had hyperlipemia, 1 had hypertension, and 1 had type 2 diabetes. Five years after surgery, the diabetes, sleep apnea, and hyperlipemia had resolved. At the 5-year (range 60-66 months) follow-up visit, the LRYGB patients had significantly lower weight and BMI and a greater percentage of excess weight loss than did the LAGB patients. Weight loss failure (BMI >35 kg/m(2) at 5 yr) was observed in 9 (34.6%) of 26 LAGB patients and in 1 (4.2%) of 24 LRYGB patients (P <.001). Of the 26 patients in the LAGB group and 24 in the LRYGB group, 3 (11.5%) and 15 (62.5%) had a BMI of 0 kg/m(2), respectively (P <.001). CONCLUSION: The results of our study have shown that LRYGB results in better weight loss and a reduced number of failures compared with LAGB, despite the significantly longer operative time and life-threatening complications.

*evil cackle*

Eeeeeexcellllllent...

Display Settings:AbstractFormatSummarySummary (text)AbstractAbstract (text)MEDLINEXMLPMID ListApply
Send to:Choose DestinationFileClipboardCollectionsE-mailOrder
FormatSummary (text)Abstract (text)MEDLINEXMLPMID ListCreate File
1 selected item: 18823860FormatSummarySummary (text)AbstractAbstract (text)MEDLINEXMLPMID ListMeSH and Other DataE-mailAdditional textE-mail"SPAM" filtering software notice
Add to Clipboard
Add to CollectionsOrder articles


Am J Med. 2008 Oct;121(10):885-93.

Gastric banding or bypass? A systematic review comparing the two most popular bariatric procedures.
Tice JA, Karliner L, Walsh J, Petersen AJ, Feldman MD.

Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143-1732, USA. [email protected]

Comment in:

Am J Med. 2009 Jun;122(6):e9; author reply e11.

Abstract
OBJECTIVE: Bariatric surgical procedures have increased exponentially in the United States. Laparoscopic adjustable gastric banding is now promoted as a safer, potentially reversible and effective alternative to Roux-en-Y gastric bypass, the current standard of care. This study evaluated the balance of patient-oriented clinical outcomes for laparoscopic adjustable gastric banding and Roux-en-Y gastric bypass. METHODS: The MEDLINE database (1966 to January 2007), Cochrane clinical trials database, Cochrane reviews database, and Database of Abstracts of Reviews of Effects were searched using the key terms gastroplasty, gastric bypass, laparoscopy, Swedish band, and gastric banding. Studies with at least 1 year of follow-up that directly compared laparoscopic adjustable gastric banding with Roux-en-Y gastric bypass were included. Resolution of obesity-related comorbidities, percentage of excess body weight loss, quality of life, perioperative complications, and long-term adverse events were the abstracted outcomes. RESULTS: The search identified 14 comparative studies (1 randomized trial). Few studies reported outcomes beyond 1 year. Excess body weight loss at 1 year was consistently greater for Roux-en-Y gastric bypass than laparoscopic adjustable gastric banding (median difference, 26%; range, 19%-34%; P < .001). Resolution of comorbidities was greater after Roux-en-Y gastric bypass. In the highest-quality study, excess body weight loss was 76% with Roux-en-Y gastric bypass versus 48% with laparoscopic adjustable gastric banding, and diabetes resolved in 78% versus 50% of cases, respectively. Both operating room time and length of hospitalization were shorter for those undergoing laparoscopic adjustable gastric banding. Adverse events were inconsistently reported. Operative mortality was less than 0.5% for both procedures. Perioperative complications were more common with Roux-en-Y gastric bypass (9% vs 5%), whereas long-term reoperation rates were lower after Roux-en-Y gastric bypass (16% vs 24%). Patient satisfaction favored Roux-en-Y gastric bypass (P=.006). CONCLUSION: Weight loss outcomes strongly favored Roux-en-Y gastric bypass over laparoscopic adjustable gastric banding. Patients treated with laparoscopic adjustable gastric banding had lower short-term morbidity than those treated with Roux-en-Y gastric bypass, but reoperation rates were higher among patients *****ceived laparoscopic adjustable gastric banding. Gastric bypass should remain the primary bariatric procedure used to treat obesity in the United States.

1. Bennett W. Dietary treatments of obesity. Ann N Y Acad Sci. 1987; 499:250-263.

2. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724-1737.

3. Tice et al. Gastric Banding or Bypass? A Systematic Review Comparing the Two Most Popular Bariatric Procedures. The American Journal of Medicine. 2008;121.

4. Angrisani L, Lorenzo M, Borrelli V. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 5-year results of a prospective randomized trial. Surg Obes Relat Dis. 2007;3:127-133.

5. Bowne WB, Julliard K, Castro AE, et al. Laparoscopic gastric bypass is superior to adjustable gastric band in super morbidly obese patients: a prospective, comparative analysis. Arch Surg. 2006;141:683-689.

I think everyone has a reason for selecting their WLS...  I know I had mine.  At the time I chose the best option for me... as time goes on and new advancements are made that may change.  I am just past 2 years post op and now have a healthy BMI.  So do I consider myself a success with my band... you betcha I do!!!!  I don't know what will come of my band in the years to come but over the past 2 years I have come across many others who have had different types of surgery and have had regain or complications.  So don't worry about where a "bandster" will be in 10-15 years.  Instead worry about where we will all be!!!  WLS is just a tool... no matter what type you have had.

I want to be YOU when I grow up (from LB) :)  what a great sucess you've had.  I'm just happy I was able to have any surgery to help me lose the weight.

Thanks!!  It was a lot of hard work but totally worth it!!  I wish you all the best on your journey...  you're doing great!