Laparoscopic Adjustable Gastric Banding—Should a Second Chance Be Given?

Abstract

Background Obesity is a chronic relapsing-remitting disease and a global pandemic, being associated with multiple comorbidities. Laparoscopic adjustable gastric banding (LAGB) is one of the safest surgical procedures used for the treatment of obesity, and even though its popularity has been decreasing over time, it still remains an option for a certain group of patients, producing considerable weight loss and improvement in obesity-associated comorbidities. Methods The aim of this study was to evaluate the impact of weight loss following LAGB on obesity-associated comorbidities, and to identify factors that could predict better response to surgery, and patient sub-groups exhibiting greatest benefit. A total of 99 severely obese patients (81.2% women, mean age 44.19 ± 10.94 years, mean body mass index (BMI) 51.84 ± 8.77 kg/m2) underwent LAGB in a single institution. Results obtained 1, 2, and 5 years postoperatively were compared with the pre-operative values using SPPS software version 20. Results A significant drop in BMI was recorded throughout the follow-up period, as well as in A1c and triglycerides, with greatest improvement seen 2 years after surgery (51.8 ± 8.7 kg/m2 vs 42.3 ± 9.2 kg/m2, p < 0.05, 55.5 ± 19.1 mmol/mol vs 45.8 ± 13.7 mmol/mol, p < 0.05, and 2.2 ± 1.7 mmol/l vs 1.5 ± 0.6 mmol/l). Better outcomes were seen in younger patients, with lower duration of diabetes before surgery, and lower pre-operative systolic blood pressure. Conclusions Younger age, lower degree of obesity, and lower severity of comorbidities at the time of surgery can be important predictors of successful weight loss, making this group of patients the ideal candidates for LAGB.

It is really time to retire laparoscopic gastric banding? Positive outcomes after long-term follow-up: the management is the key

“…Conversely, opposite results were reached by Leca et al on 99 LAGBs. They identified, in fact, better anthropometric outcomes in younger age, lower degree of obesity, and lower severity of comorbidities at the time of surgery which were considered predictors of successful weight loss [ 50 , 51 ].…”

Do All Bariatric Surgery Methods Have the Same Effects on the Gut Microbiota?

“…One of the most secure surgical methods used to treat obesity is LAGB. [24] Firstly, in 1993, laparoscopic adjustable gastric banding was described by Belachew. Since then, the LAGB has undergone many changes, revisions, and corrections to become the way it is now defined.…”

“…Increasing the effect of weight loss without compromising safety by adjusting the band is another benefit of this method. An option that makes LAGB attractive to most patients is that it is a reversible form of laparoscopic surgery, although it is not touted as a temporary method due to the considerable risk of regaining weight after removal [24]. LAGB at first accounted for most methods and affected weight loss by a restrictive mechanism [26].…”

“…LAGB at first accounted for most methods and affected weight loss by a restrictive mechanism [26]. And indeed even though its popularity has been diminishing over time, it remains a choice for a specific group of patients, creating significant weight loss and improving obesity-associated comorbidities [24]. Due to the lack of any resection or anastomosis, reversibility, low life-threatening complications, and a minimally invasive intervention, LAGB surgical procedure seems to be useful [27].…”

Comparação entre as principais técnicas cirúrgicas para o tratamento da obesidade: revisão da literatura / Comparison between the major surgical techniques for the treatment of obesity: literature review

“…Geralmente é escolhida como segunda abordagem cirúrgica devido ao possível ganho de peso após remoção (LECA et al;2020;KAWAI;COELHO;GARCIA, 2017).…”