Laparoscopic Adjustable Silicon Gastric Banding versus Sleeve Gastrectomy

Abstract

Background and purpose: Obesity now forms one of the leading public health concerns globally. Several surgical options including sleeve gastrectomy exist for its treatment. Recently, laparoscopic gastric banding has been developed with the aim of providing a laparoscopically placed device that is safe and effective in generating substantial weight loss. The goal of this review is to compare the effectiveness and safety of laparoscopic adjustable silicon gastric banding (LASGB) and laparoscopic sleeve gastrectomy (LSG) in the treatment of morbid obesity by reviewing the methods of patient selection, operative time, conversion rate, complications, blood loss, postoperative morbidity and mortality, hospital stay, and quality of life. Material and methods:A systematic literature search was performed using Highwire press, Springer link, Medline, Medscape and Google, and article bibliographies to identify relevant evidence. Included studies must have reported outcome data for more than 40 patients aged 20 years and above with a minimum of one 1-year follow-up. The operating time, complications, blood loss, hospital stay, morbidity and mortality, and quality of life were reviewed. Results:The total number of patients enrolled was 4,519; the specific procedure totals were 3,714 for LAGB and 805 for LSG. The age range of the population studied was 13-79 years for LSG and 18-65 years for LAGB. The sex distribution had a male:female ratio of 1:4 for LAGB and 1:3 for LSG. The overall complication rate in this review varied from 1.7-11. 80% for LSG and 0.2-24% for LAGB. Conclusion:Laparoscopic sleeve gastrectomy though, forms a safe surgical option for weight loss treatment particularly in the veryvery-obese patients (BMI > 60 kg/m 2 ). LASGB gives satisfactory results and coupled with reversibility and low cost, it is an important tool in the long-term management of patients with morbid obesity.