Laparoscopic Gastric Banding: Is a Bigger Band Better?

Katherine S Graw, MD, Mohamad Dahman, MD, Cyrus Jahansouz, Tjasa Hranjec, MD, Bruce Schirmer, MD, Anna Dietrich-Covington, Peter T Hallowell, MD. The University of Virginia

Introduction: Laparoscopic placement of gastric bands for weight loss has become commonplace and there are multiple types and sizes of gastric bands on the market today. The goal of our study is to compare excess weight loss (EWL) at 1 year for each of the four band types utilized at our institution.

Methods: We analyzed a prospectively maintained database which included all patients with laparoscopically placed gastric bands at the University of Virginia from September 2004 to October 2009. All band insertions utilized similar laparoscopic technique by 3 different surgeons. Four different band types were utilized: AP Standard [Allergan], AP Large [Allergan], Realize [Ethicon], and the VG [Allergan]. Patient weight was recorded at one year follow-up and calculated as a percentage of loss (or gain) based on ideal body weight. A Student’s t-test was then utilized to compare the mean EWL to determine significance. Those patients without adequate follow-up were discarded from the data set.

Results: 174 gastric band patients from our 322 patient database had sufficient information for analysis. The mean EWL for the AP Standard, AP Large Bands, the Realize and VG bands were 44.8 (±3.3), 30 (±3), 34.6 (±2.4) and 29.2 (±1.9) respectively. Student T-test revealed a p-value of 0.0128 when comparing the AP Standard band to the Realize band.

Conclusions: Patients who receive the AP Standard band will have a greater excess weight loss in the first year after placement, when compared to other bands in our analysis.