Laparoscopic Gastric Banding Is Safe in Outpatient Surgical Centers

Cobourn, Chris; Mumford, David; Chapman, Mary Ann; Wells, Leandra

doi:10.1007/s11695-009-0065-7

Cited by 41 publications

(34 citation statements)

References 19 publications

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“…There was no association between higher BMI and non-ambulatory LAGB outcomes. This finding is supported by similar findings of Cobourn et al in a series of 1,641 patients (18).…”

Section: Discussionsupporting

confidence: 89%

“…The 2006 American Society of Anesthesiologists practice guidelines for perioperative management of patients with OSA were developed with the aim to help practitioners make rational decisions and provide optimal perioperative care to those patients (17). However, some practitioners do not consider appropriately treated as a contraindication for ambulatory LAGB (6,18). Such an approach is actually supported by this study that demonstrated similarities in non-ambulatory (39.1%) and ambulatory outcomes (37.4%) of patients with OSA (p=0.83).…”

Section: Discussionsupporting

confidence: 53%

“…Skilled surgeons require roughly 1 h of operative time for completion of LAGB (8,18). Reported conversion rates to an open procedure have ranged from 0% in private practice settings to 8% at academic institutions where residents are involved (6,7).…”

Section: Discussionmentioning

confidence: 99%

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Perioperative Factors Affecting Ambulatory Outcomes Following Laparoscopic-Adjustable Gastric Banding

Dupanovic¹,

Krebill²,

Dupanovic³

et al. 2017

Turk J Anaesth Reanim

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Objective: Morbidly obese patients are traditionally hospitalised following bariatric surgery. However, laparoscopic-adjustable gastric banding (LAGB) is amenable for ambulatory care. We hypothesised that the majority of patients can receive an ambulatory LAGB and that both surgical and anaesthetic perioperative factors will significantly affect non-ambulatory LAGB outcomes.Methods: Medical records of 201 consecutive LAGB patients performed at the University of Kansas Medical Centre during a 3-y period were reviewed. Demographic, medical, laboratory, anaesthetic, intraoperative and postoperative data were collected. Factors associated with non-ambulatory outcomes were identified and analysed using logistic regression, and a classification tree analysis was used to rank the descriptive model factor to the non-ambulatory outcome.Results: Average patient age was 43.4±11.4 years, and average body mass index was 48.2±10.3 kg m 2-1 . A total of 155 patients (77.1%; 95% confidence interval, 71%-83%; p<0.0001) were discharged home within 2-3 hours of surgery, whereas 36 stayed for 23 hours and 10 required hospital admission for 1-2 days. Increased surgical port numbers (p=0.007), ≥50% of total intraoperative fentanyl administered in the recovery room (post-anaesthesia care unit) for the treatment of postoperative pain (p=0.007) and a lack of prophylactic beta-blockade (p=0.001) were three factors associated with non-ambulatory outcomes. Obstructive sleep apnoea was not associated with a non-ambulatory outcome (p=0.83). Conclusion:The majority of patients received an ambulatory LAGB. Meticulous laparoscopic surgical technique with the least feasible number of access ports and multimodal analgesic technique aimed at reduction of postoperative opioid consumption are the most important factors for a successful ambulatory LAGB outcome.Keywords: Ambulatory surgery, bariatric surgery, laparoscopic surgery, outpatient surgery Abstract Address for Correspondence: Mirsad Dupanovic

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“…There was no association between higher BMI and non-ambulatory LAGB outcomes. This finding is supported by similar findings of Cobourn et al in a series of 1,641 patients (18).…”

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 53%

See 1 more Smart Citation

Perioperative Factors Affecting Ambulatory Outcomes Following Laparoscopic-Adjustable Gastric Banding

Dupanovic¹,

Krebill²,

Dupanovic³

et al. 2017

Turk J Anaesth Reanim

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“…The standardized pars flaccida technique was used. 17 The band reservoir was gradually filled with 6.5 mL of saline. The band reservoir was additionally filled with 2 mL of saline in the 4th and 8th week after the procedure.…”

Section: Methodsmentioning

confidence: 99%

Initial Weight Loss after Restrictive Bariatric Procedures May Predict Mid-Term Weight Maintenance: Results From a 12-Month Pilot Trial

Nikolić

Kruljac

Kirigin

et al. 2015

Bariatric Surgical Practice and Patient Care

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Background: Bariatric procedures are effective options for weight loss (WL) in the morbidly obese. However, some patients fail to lose any weight after bariatric surgery, and mid-term weight maintenance is variable. The aim of this study was to investigate whether initial WL could predict mid-term weight maintenance. Methods: Eighty patients were enrolled, of whom 44 were treated with the BioEnterics Intragastric Balloon (BIB), 21 with laparoscopic adjustable gastric lap-banding (LAGB), and 15 with laparoscopic sleeve gastrectomy (LSG). Percentage of body WL and percentage of excess weight loss (EWL) were calculated at baseline and after 1, 3, 6, and 12 months. Successful WL was defined as EWL > 20% for patients treated with BIB and > 50% for patients treated with LAGB and SG. Results: Success in the 6th and 12th month was achieved in 80% and 58% of patients in the BIB group, 33% and 40% in the LAGB group, and 60% and 73% in the LSG group. In the BIB group, WL in the 1st month correlated positively with WL at the 6th and 12th month, and an initial WL > 6.5% best predicted success (sensitivity 50%, specificity 80%). A similar association was observed in the LAGB group at the 6th and 12th month and an initial WL > 9.4% best predicted success (sensitivity 90.0%, specificity 81.2%). In patients treated with LSG, WL in the 3rd month correlated positively with EWL at the 6th and 12th month, with a cutoff value of 17% (sensitivity 66.7%, specificity 100%). Conclusions: WL in the 1st month in patients treated with BIB and LAGB and WL in the 3rd month in patients treated with LSG could be used as a prognostic factor to predict mid-term weight maintenance.

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“…83,84 LAGB surgery generally has a low risk of mortality and morbidity. 40 Mortality rates are on the order of 1:1000 to 3000, which is comparable to or lower than that of common abdominal procedures such as appendectomy and cholecystectomy.…”

Section: Safety Early To 1 Yearmentioning

confidence: 99%

Laparoscopic Adjustable Gastric Banding and Other Devices for the Management of Obesity

et al. 2012

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Laparoscopic Gastric Banding Is Safe in Outpatient Surgical Centers

Abstract: The ability to treat patients within 4 h and the extremely low complication rates reported here contribute to a growing literature supporting the safe performance of LAGB in an outpatient setting for the treatment of morbid obesity.

Cited by 41 publications

References 19 publications

Perioperative Factors Affecting Ambulatory Outcomes Following Laparoscopic-Adjustable Gastric Banding

Perioperative Factors Affecting Ambulatory Outcomes Following Laparoscopic-Adjustable Gastric Banding

Initial Weight Loss after Restrictive Bariatric Procedures May Predict Mid-Term Weight Maintenance: Results From a 12-Month Pilot Trial

Laparoscopic Adjustable Gastric Banding and Other Devices for the Management of Obesity

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