Complication and Outcome of Laparoscopic Adjustable Gastric Banding (lagb)

Karamollah Toolabi, Saeed Arefanian. Tehran University of Medical Sciences


 Obesity has many co-morbidities. Commercial and pharmacologic assisted diets show little success in severely obese patients. Several surgical procedures (Jejunoileal bypass, vertical and horizontal banded gastroplasty, gastric bypass, biliopancreatic diversion and gastric banding) developed in order to reach more acceptable long-term outcomes. Therefore we perform this study to evaluate outcomes and complications of a low pressure band (MID-BAND®) in LAGB technique.

Eighty patients were operated by LAGB from May 2003 to June 2007 with BMI of more than 40 kg/m^2 or more than 35 kg/m^2 with at least one co-morbidity of obesity. Mean BMI was 44.8?7.1 kg/m^2. We used Pars Flaccida procedure with five trocars including three 5mm, one 10mm and one 12mm with reverse trendelenburg position. Bands were adjusted 4 to 6 weeks after operation for the first time with Ultravis® inflation. Patients follow up was performed monthly up to 3 months, in months 6, 12, and then annually.

Seventy seven patients (66 women and 11 men) with a mean preoperative age of 33.6?10.6 years (range, 19-56) have been followed since 2003. The mean %EWL in the first and second year follow up was 62?3.1% (range, 34-95%) and 54.5?2.6% (range, 21-90%), respectively. Early complication rate was 5% (n=4) consisting of dysphagia and halothane induced hepatotoxicity and late complication rate was 53.2% (n=41) with band migration/gastric erosion the most common one (19.4%, n=15). Twenty six laparoscopic reoperations were performed for purposes such as port position correction, collection drainage, and band extraction.

The high rate of gastric erosion (19.4%) and reoperation in this study imply that low pressure bands cause more gastric erosion than reported for high pressure bands. In our practice, we do not consider that LAGB has low rate of major complications. We prefer other methods of bariatric surgery such as LRYGBP and Sleeve gastrectomy for morbid obesity.

Session Number: Poster – Poster Presentations
Program Number: P507
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