As I suspected, the Lap band "High Complication Rate" is Misleading and False, this new study clarifies this as indicated below by stating the lap band has a "High Re-operation rate", which can be many things that are NOT serious such as mechanical issues, due to ports or other not serious or life threatening issues and can be easily fixed.

Enjoy: and Happy Holidays!

DO THE MATH 
164 Studies, 
161,756 Patients 
Over Nearly 10 Years:
What Does This Add Up To?

BARIATRIC AND METABOLIC SURGERY IS EVEN MORE EFFECTIVE THAN PREVIOUSLY REPORTED AND GETTING SAFER!

A new meta-analysis of studies carried out between 2003 and 2012 shows higher remission rates of diabetes and high blood pressure and a lower mortality rate than previously reported. The study, published online in JAMA Surgery, is an update to a meta-analysis of studies conducted between 1990 and 2003 and published in the Journal of the American Medical Association (JAMA, Buchwald et. al.) back in October 2004.

Researchers from Washington University School of Medicine in St. Louis reviewed outcomes from nearly 162,000 patients in 164 studies (37 randomized clinical trials and 127 observational studies), over almost 10 years.

They discovered 92 percent of patients in randomized clinical trials experienced diabetes remission after surgery, slightly higher than the 86 percent remission rate found in observational studies, but significantly higher than the 76.8 percent remission rate found in the 2004 JAMA study.

Remission rates for hypertension were about 75 percent in both the randomized clinical trials and observational studies, while the remission rate in 2004 was 61.7 percent. Body Mass Index (BMI) loss five years after surgery ranged from 12 to 17 in the new study. Before surgery, patients had an average BMI of 45.62.

"With the 2004 study, we now have 22 years worth of data from over 180,000 patients and 300 studies," said study co-author J. Esteban Varela, MD, MPH, MBA, Fellow of the ASMBS. "The data continues to prove bariatric surgery is not only safe and effective in providing significant and sustainable weight loss, but is the most effective treatment today for diabetes, hypertension and an array of other diseases and conditions in people with obesity."

In the new study, 30-day mortality rate was 0.08 percent, down from the 0.3 percent reported in 2004. Complication rates ranged from 10 to 17 percent and the reoperation rate was about 7 percent. Complication and reoperation rates were not reported in the previous meta-analysis.

By procedure, gastric bypass and sleeve gastrectomy resulted in the greatest weight loss, but had a higher rate of complications and mortality than adjustable gastric banding. Gastric banding had the highest reoperation rate (12% in randomized trials), while gastric bypass had the lowest at 3 percent, followed by sleeve gastrectomy, which had a reoperation rate of 9 percent. The new meta-analysis included sleeve gastrectomy, which was not available in the 1990s. Of note, sleeve gastrectomy had comparable weight loss to that of gastric bypass at 5 years.

"This is but the latest study to validate the high degree of safety and effectiveness of bariatric surgery," said Ninh T. Nguyen, MD, FACS, President of the American Society for Metabolic and Bariatric Surgery (ASMBS) and Vice-Chair of the Department of Surgery at UC Irvine School of Medicine. "Today we are performing operations that are as safe or safer than gallbladder and hernia repair surgery."

According to the Centers of Disease Control and Prevention (CDC), more than 78 million adults were obese in 2011–2012.¹ The ASMBS estimates about 24 million people have severe or morbid obesity. Individuals with a BMI greater than 30 have a 50 to 100 percent increased risk of premature death compared to healthy weight individuals as well as an increased risk of developing more than 40 obesity-related diseases and conditions including type 2 diabetes, heart disease and cancer.^2,3

By procedure, gastric bypass and sleeve gastrectomy resulted in the greatest weight loss, but had a higher rate of complications and mortality than adjustable gastric banding. Gastric banding had the highest reoperation rate (12% in randomized trials), while gastric bypass had the lowest at 3 percent, followed by sleeve gastrectomy, which had a reoperation rate of 9 percent. The new meta-analysis included sleeve gastrectomy, which was not available in the 1990s. Of note, sleeve gastrectomy had comparable weight loss to that of gastric bypass at 5 years.

You say Tomato I say Tomatoe Some may read this as NOT wanting to be re-operated on at a higher rate (BAND) and losing More weight if they chose the gastric bypass. 

I believe that point of the Article was the BARIATRIC Surgery is Safer.

"The data continues to prove bariatric surgery is not only safe and effective in providing significant and sustainable weight loss, but is the most effective treatment today for diabetes, hypertension and an array of other diseases and conditions in people with obesity."

they didn't specify LB as the World's Greatest, nor did I read any "NEW" percentage on the complication rates it says 12% Well that is actually HIGHER than what Allergan has publicly stated. SO If anything it seems like the rate is higher now not lower, But if you have something that states that REAL rates I'd Love to read it ! 

I wasn't impressed when they posted this to the Bari site still not impressed, but it's Ok you won't get as many rebuttal's here as you do there...lol

Happy Holidays!

When you compare the lap band with the Sleeve in this study, the Sleeve ACUTALLY is worse than both RNY and Lap Band -- it has a HIGH re-operation rate as well as HIGH complication rate -- 9 percent re-op rate IS HIGH.

RNY has the lowest reoperation rate, HOWEVER, it has the HIGHEST deadliest complication rate, just because you don't have to be "re-operated on" frequently does not mean you don't have ANY issues or life threatening or debilitating chronic issues. However more people have the Bypass than Lap band so you will get more complications.

MOST of the Lap band issues are "self inflicted" which contributes to the "HIGH" re-op rate. Band slippage issues are different than port and mechanical issues than can go wrong, but most people don't have mechanical issues with banding.

I was part of the statistics of "HIGH" re-ops, but I am "honest" and admit to why I had to be re-operated on, which was a inflamed hiatal hernia and that was caused by eating too much yummy salsa and chips which was spicy and forgetting I had a lap band at 7 years post op, but the older 4cc bands are harder on the body since they are higher pressure and can easily cause more complications than the new bands.

Some people have insurance that will pay for any mechanical issues or band issues, so hopefully others who get a band will take that risk into consideration, If I was "self pay" I would NOT have gotten a new band, but as long as my insurance pays for any "fixes" I will continue to upgrade or fix any future problems that could crop up even if it means another operation, but hopefully I will not have to have any more future operations.

I am grateful and humble that I was given a "second chance" with a safer band at almost 9 years to keep my weight under control. And Oh, my new band works like a charm -- not one issue so far, (I had many with my old band at this point), and I can't over eat if I wanted too.

Peace out.
Nana

When you compare the lap band with the Sleeve in this study, the Sleeve ACUTALLY is worse than both RNY and Lap Band -- NO one  BUT YOU were Comparing them  If you READ it again they stated that "

BARIATRIC AND METABOLIC SURGERY EVEN MORE EFFECTIVE THAN PREVIOUSLY REPORTED AND GETTING SAFER" 

It didn't say LB, Sleeve, RNY ............

When you compare the lap band with the Sleeve in this study, the Sleeve ACUTALLY is worse than both RNY and Lap Band -- it has a HIGH re-operation rate as well as HIGH complication rate -- 9 percent re-op rate IS HIGH. 

Well your the one comparing again and 12% is STILL HIGHER

MOST of the Lap band issues are "self inflicted" which contributes to the "HIGH" re-op rate. 

There you go ASSUMING again, Like I said IF and WHEN you find actual FACTS I'd love to see them.

Some people have insurance that will pay for any mechanical issues or band issues, so hopefully others who get a band will take that risk into consideration, If I was "self pay" I would NOT have gotten a new band, but as long as my insurance pays for any "fixes" I will continue to upgrade or fix any future problems that could crop up even if it means another operation, but hopefully I will not have to have any more future operations.

I hope you don't need anymore either, personally 1 re-operation is too many.

I am grateful and humble by definition: having or showing a modest or low estimate of one's own importance.  Nope, don't believe it ;)  that I was given a "second chance" with a safer band at almost 9 years to keep my weight under control. And Oh, my new band works like a charm -- not one issue so far, (I had many with my old band at this point), and I can't over eat if I wanted too.

Since you so WELL versed on the band I'm sure you've seen this article it's pretty self explanatory. But.. Give it time your only a year out from your "new" band.

High secondary failure rate of rebanding after failed gastric banding.

http://www.ncbi.nlm.nih.gov/pubmed/17593435

Peace out. We can only hope 
Nana

Just proves that how it's written and how one interprets it the article can say MANY different things 

NEW YORK (Reuters Health) - Bariatric surgery results in substantial weight loss and can turn back some diseases related to obesity, a new study finds.

There is some risk of complications, but death rates appear to be lower than previously thought, researchers reported after reviewing about a decade's worth of recent data.

They were interested in updating current knowledge about the effectiveness and safety of various types of weight loss surgery, including gastric bypass, adjustable gastric banding (lap banding), vertical banded gastroplasty and sleeve gastrectomy.

These surgical procedures are used for people who are severely obese, or moderately obese with serious weight-related health problems. The last time there was a major update of bariatric surgical research was in 2003.

"Previous reviews included data from clinical trials and studies published before 2003, but because of advances in technology of bariatric surgery and accumulation of surgeons' experience, information provided in previous reviews is outdated," Su-Hsin Chang told Reuters Health in an email.

Chang is an instructor with the Division of Public Health Sciences, Department of Surgery at the Washington University School of Medicine in St. Louis, Missouri and led the new study.

"We planned to answer general questions regarding effectiveness and risks of surgical treatment of obesity and which surgical procedure is the most efficacious," Chang said.

The results were published in JAMA Surgery.

The researchers reviewed 164 studies conducted from 2003 to 2012, whi*****luded a total of 161,756 patients. On average, the patients were about 45 years old and almost 80 percent were female.

The average body mass index (BMI), a measure of weight relative to height, of patients before surgery was nearly 46. A BMI of 18.5 to 24.9 is considered normal weight and a BMI of 35 or higher is considered obese.

Patients' presurgery weight averaged 274 pounds. More than a quarter of patients had diabetes, nearly half had high blood pressure and almost 30 percent had high cholesterol. Seven percent had heart disease and 25 percent had sleep apnea.

Chang's group found that patients' BMI dropped by an average of 12 to 17 points within 5 years after surgery. The researchers also found that diabetes, high blood pressure and sleep apnea improved significantly.

Between 86 percent and 92 percent of patients with diabetes experienced remission of the disease. The same happened for about 75 percent of those with high blood pressure.

High cholesterol and heart disease were rolled back at slightly lower rates, but sleep apnea disappeared or improved dramatically in more than 90 percent of those who had it pre-surgery.

Death rates ranged from 0.08 within one month of surgery to 0.31 after 30 days. Complication rates ranged from 10 percent to 17 percent and the proportion of operations that needed to be repeated was 6 percent to 7 percent.

Gastric bypass surgeries were the most effective in terms of long-term weight loss, but the procedure had the highest complication rates. Sleeve gastrectomy was almost as effective as gastric bypass. Adjustable gastric bands (lap bands) weren't quite as effective but were the safest.

"Weight loss surgery provides substantial effects on weight loss and improves obesity-related conditions in the majority of bariatric patients, although risks of complication, reoperation and mortality exist," Chang said. ALL SURGERIES

"The article is very interesting and overdue," Dr. Pratt Vemulapalli told Reuters Health in an email.

Vemulapalli is director of bariatric surgery and an associate professor of surgery at the Montefiore Medical Center of the University Hospital for the Albert Einstein College of Medicine in New York. She was not involved in the study.

"Those of us doing bariatric surgery have seen this with our own patients and in studies that have been published in the literature but this meta-analysis simply ties that data together and has wrapped the impression like a present in a neat package," she said.

Vemulapalli said there are currently about 200,000 weight loss procedures performed each year. She said the most common procedures are the gastric bypass, the sleeve gastrectomy and, to a lesser extent, the adjustable gastric band. DOING less? REALLY I wonder why???

"The article itself was very well done, and shows that the surgeons and centers who do surgery know how to do the operations, know which patients to operate on and how to identify and treat complications," she said, "All of this makes for safer surgery."

SOURCE: http://bit.ly/1cNdLW6 JAMA Surgery, online December 18, 2013.

http://news.yahoo.com/weight-loss-surgery-safe-beneficial-st udy-164815855.html

I attended a Bariatric Meeting in Dallas recently.  It was just for area surgeons.  It was overwhelming evidence that the LapBand is rarely done anymore.  In the group present, they had gone from doing 200 on the average Bands a year to 5 or less in 2013.  They did say that the ones they did were most successful at losing weight than any other WLS procedure in their offices.  We all agreed they probably were that way because they were told the honest truth, they were given a device that could very well be temporary and would have to be removed, they would have to do the work and do it well and not push the limits of fills.  I found that all very interesting.  I sat there with my enormous loss with the Band and was a bit offended by the negativity in the room with all the surgeons.  One said, he flat our refuses to do Bands anymore and any surgeon who will do one is only out to get the money.