Predictors of outcome in treatment of morbid obesity by laparoscopic adjustable gastric banding: results of prospective study of 380 patients.

Bettina K Wölnerhanssen, Thomas Peters, Beatrice Kern, Andy Schötzau, Christoph Ackermann, Markus von Flüe, Ralph Peterli

Department of Surgery, St. Claraspital, Basel, Switzerland.

Journal Article: Surgery for Obesity and Related Diseases (impact factor: 3.86). 06/2008; DOI: 10.1016/j.soard.2008.03.252

Abstract

BACKGROUND: We investigated the outcome predictors of laparoscopic gastric banding (LAGB) for morbidly obese patients. METHODS: From December 1996 to November 2004, a total of 380 consecutive unselected patients (78% female; median age 40 yr, range 17-66; body mass index 44.3 kg/m(2), range 35-75) were prospectively evaluated and underwent LAGB. The follow-up rate after a median of 5 years (range 1.5-9.4) was 98%. A survival model was applied, and a multivariate Cox proportional hazard model was used to calculate the hazard ratios for the influential factors. RESULTS: Of the 380 patients, 128 (33.7%) had their bands removed. Of these 128 patients, 2.4% declined another operation, 18.2% underwent biliopancreatic diversion with duodenal switch, 7.1% underwent laparoscopic Roux-en-Y gastric bypass, and 6% underwent laparoscopic sleeve gastrectomy. The excess weight loss of the remaining 252 patients (66.3%) with a band in situ (including 21 patients after rebanding) was 40%, and only 25% reached an excess weight loss >50%. Older age, binge eating disorder, and sweet-eating behavior were predictors of a poor outcome after LAGB. In contrast, sex, primary body mass index, and co-morbidities had no influence on outcome. CONCLUSION: LAGB was less successful in older patients and in patients with binge eating disorder or sweet-eating behavior. These patients might be candidates for a different bariatric procedure.

Source: PubMed

My surgeon and his staff were very informative, therefore,   I knew from the get-go that most patients will not lose more than 40% of their excess weight.  I was also informed that changes in diet were necessary; especially sweets. 

Its encouraging that in this study, 66.3%, were successful in their weight loss.

I think we're all looking for a magic pill, but there is nothing out there that isn't going to require real change and commitment in order to lose weight.  But wouldn't it be great if there was such a pill?? 

On March 28, 2012 at 7:45 AM Pacific Time, c_cubed wrote: I think we're all looking for a magic pill, but there is nothing out there that isn't going to require real change and commitment in order to lose weight.  But wouldn't it be great if there was such a pill?? 




I think we're all looking for a magic pill, but there is nothing out there that isn't going to require real change and commitment in order to lose weight.  But wouldn't it be great if there was such a pill?? 


There is! I just found them on Amazon! We didn't need WLS after all. Who knew?!





Gotta go! I've got to order mine before they sell out!!! Lol.

You have got to be the CRAZIEST lady on the 'web!! 

HAHAHAHAHAHAHAHAHAHAHAHAHAHA 

I'm gonna get some stock in those pills ASAP!!!

Oops! My graphic didn't show up when I responded.

OMG you make me laugh!!!!!!!!!!!!! LOL

It dont matter what WLS you have done. You and You alone still have to make the choice do I eat the bag of chips with dip or do I get a piece of fruit or some veggies to munch on instead.

No surgery is going to tell you before you put them chips in your mouth nope you cant eat that , you still have to make them decisions yourself. Sleeve, RNY, Lapband and whatever else is out there .

It's true that no weight loss surgery is going to tell you what you can and can't eat, but for me, it was more about the extreme damage the lapband caused to my internal organs. The other surgeries remove and rearrange, but it's done in a controlled environment with a skilled surgeon.

The lapband, however, damages the soft, muscular tissue of the stomach as well as the surrounding organs. There's no control as to what gets affected. I'd rather have a skilled surgeon cut away part of the stomach than have the band do it with no rhyme or reason.

Imagine if you had a tight belt wrapped around your midsection for years at a time... even though it's not soft tissue like the stomach... you'd have an infection and your skin would become horribly damaged. The stomach tissue is much more reactive and much more prone to damage. It doesn't take much for it to become inflamed, swollen, irritated, and ultimately damaged.

Very true Nikki , i knew the risks of getting this done but the others have serious issues also it can be just as life threatening if not worse sometimes .

The girl next door to me had the gastric done and she is fighting for her life right now.  She told me the other day with tears she would rather be fat then go through what she is going through right now . She has lost her job as a RN , lost her kids , spent months in the hospital and still goes back every couple of months with problems she cant even take proper care of her kids right now due to all the illness she has .

I know more bad stories on the gastric then I do the lap band .  Everybody I know that has had the gastric has nothing but problems expect for a very few.

When you are overweight, you know you will probably die if you dont get the weight off you , you will do anything to get the weight off you even knowing that you can die on the table, have minor to major complications later on down the road.  At this point we just dont care.  We are willing to take these huge risks for any of the surgeries , lap band, gastric, sleeve, or even the DS.

Would I do the band all over again ? I honestly dont know . I cant say yes and I cant say no.  I wish I knew how strong of a person I really was before I had the surgery done..  The band has taught me I am a very strong person and mindset on something when I need to be .   That is one of the reasons why I haven't gotten a fill yet , I have it so set in my mind now that I dont need to go back for seconds, or thirds on things now for my meals,  and plus if I would get a fill it would make me a little tighter then I want to be according to my yearly check up and to me that is not worth it .  I would rather have some self control then take a chance of having a tight band where problems start.

Wish every surgery we got there was no complications or people going back for second surgeries but as we all know every surgery has risks some more then others but when you are fat and miserable those risks are worth it and we will take them .