Laparoscopic Adjustable Gastric Banding

Belachew, M; Legrand, M; Vincent, Michel Lismonde Vernon; Docte, Nicole Le; Deschamps, V.

doi:10.1007/s002689900499

Cited by 234 publications

(70 citation statements)

References 31 publications

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“…Outside of the United States, laparoscopic gastric banding has been shown to be a very effective weight-loss procedure [1,2,4,6,15,30,31,37]. The technique has been modified during the past 8 years.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic adjustable gastric banding for massive superobesity ( > 60 body mass index kg/m 2 )

Fielding¹

2003

Surgical Endoscopy

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Surgery for massive super obesity is a formidable challenge. No existing open or laparoscopic procedure reduces BMI below 30 from a starting point above 55. Laparoscopic adjustable gastric banding has been used to treat 76 massive super obese patients with a BMI > 60 kgs/m2. Median weight was 193 kgs +/-34.7 kgs (154-335 kgs). Five patients had a BMI > 100 kgs/m2. There was neither mortality nor pulmonary emboli. hospital stay was 3 days (1-6 days). Excess weight loss was 46.69 +/-10.5 at 1 year; 59.14 +/- 11.7% at 3 years and 61 +/- 15.1% at 5 years. At 2 years, 84% of the patients had greater than 50% excess weight loss and this was maintained at 3, 4, and 5 years. BMI fell from 69 +/- 6.2 to 49 +/- 7.73 at 1 year to 37 +/- 4.45 at 3 years and this was maintained at 4 and 5 years. BMI in 13 patients with > 5 year follow up was 35.09 +/- 53 kgs/m2 (27-44). Weight loss with laparoscopic adjustable gastric banding in this group of massive super obese patients has been similar to all other surgical techniques with reduction of BMI from 69 to 33 kgs/m2 at 3 years. The relative safety of the Lapband avoids bowel surgery in these very big patients, suggesting that laparoscopic adjustable gastric banding is a valid surgical approach to these difficult patients.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic adjustable gastric banding for massive superobesity ( > 60 body mass index kg/m 2 )

Fielding¹

2003

Surgical Endoscopy

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“…The main reasons for the mini-invasive laparoscopic approach are the comfort of the patient with regard to postoperative pain and aesthetic surgery after weight reduction. The reported reduced complication rate is an effect of limiting the numbers of surgeons [7,15,21,53]. It does not mean that the approach is unimportant, we prefer the laparoscopic one in any case, but bariatric surgery is involved with more significant questions.…”

Section: Discussionmentioning

confidence: 89%

“…Similar to general visceral surgery, the mini-invasive approach is a very well accepted method [7,13,18,20]. Laparoscopic surgery is a revolution from the technical point of view, with the development of better optical devices and better-designed instruments.…”

Section: Operating Approachmentioning

confidence: 99%

Open-surgery management of morbid obesity: old experience?new techniques

Husemann¹

2003

Langenbeck's Archives of Surgery

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Bariatric surgery is well established to treat morbidly obese patients (BMI >40 kg/m 2 ) with various techniques. Gastric-restriction procedures [adjustable gastric band, vertical banded gastroplasty (VBG)] reduce caloric intake and are well accepted (weight loss up to BMI 28-33 kg/m 2 after 5 years), but they are less effective in super-obese patients and in sweet-eaters. For that group combined techniques, such as duodenal switch, gastric bypass or biliopancreatic diversion, could produce a better weight loss (between 60 and 160 kg or BMI of 25-30 kg/m 2 ) with acceptable long-term side effect; however, due to malabsorption, a lack of minerals and vitamins, even protein, could occur and have dangerous side effects. Both basic techniques have their place in the treatment of morbid obesity. The surgical approach-open or mini-invasive-is only of minor importance. Technical complications should be avoided, especially band dislocation (2-12%) or suture leak. Long-term follow-up is very important because obesity is a chronic disease with a high risk of recurrence, even after bariatric surgery.

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“…Recently, several series of patients having undergone laparoscopic gastric banding have been published. The early results in most European and Australian reports have generally been relatively good, with a low perioperative morbidity, a very low mortality, and a satisfying average excess weight loss [2,8,11,15,16,17,20,25,27,30]. Others have reported less favorable results with insufficient weight loss and/or high long-term complications rates [9,31].…”

Section: Discussionmentioning

confidence: 96%

“…Hence, the demand for bariatric surgery, the only efficient treatment for morbid obesity currently available, is rapidly expanding. Whereas Roux-en-Y gastric bypass remains the gold standard, and despite the fact that the method is relatively new, many authors consider laparoscopic gastric banding as the treatment of choice for morbidly obese patients [2,11,13,15,17,18,20,30]. Others consider gastric banding as an inappropriate method because it yields insufficient weight loss or because it is associated with an exceedingly high rate of complications [9,31].…”

mentioning

confidence: 99%