South American Experience in Laparoscopic Adjustable Gastric Band: 5 & 10 years of follow-up

Martin A Berducci¹, Jorge Nefa¹, Magali Sanchez², Natalia Pampillon², Viviana Lasagni², Cecilia Penutto², Romina Palma², Mariela Abaurre², Sonia Omelanczuk², Pablo E Omelanczuk¹. ¹Hospital Italiano de Mendoza, Argentina, ²Clinica Quirurgica de la Obesidad, Mendoza, Argentina

Background: The laparoscopic adjustable gastric band (LAGB) is a surgical procedure to patients with morbid obesity, now no longer used in some surgical centers by the advent of other surgical techniques such as Sleeve Gastrectomy.

Aim: Show effectiveness of the procedure and its long-term complications.

Design: Retrospective, observational study in Obesity Surgery Center at Mendoza, Argentina.

Methods: It took as inclusion criteria patients undergoing laparoscopic adjustable gastric band with pars flaccid technique from April 2004 to October 2010 with Body Mass Index (BMI) greater than 40 or BMI of 35 with comorbidities in older than 18 years old. Sex, age, complications, revision surgeries, and preoperative BMI% Excess Weight Lost (% EWL) was recorded at 1, 5 and 10 years.

Results: 117 patients were analyzed, with a mean age of 40.66 years, with 83% of female patients. The preoperative BMI was 47.13 kg/m2. The %EWL at the 1st, 5th and 10th postoperative year were 39.70%, 56.95% and 34.12% with a follow up of 90%, 75% and 70%, respectively. In regard to complications: 1) five slippage that were repositioned laparoscopicaly, 2) one laparoscopic band removal by a leaked at the band system, 3) 4 endoscopic band removal by erosion and 4) A port infection occurred, it was replaced. Conversion surgery was performed in 12 (10.25%) patients due to insufficient weight loss (<15% EWL), of which 10 patients to Sleeve Gastrectomy and 2 patients to Roux en Y Gastric Bypass.

Conclusion: The LAGB as one of the treatment options for morbid obesity in our series showed disappointing results in weight reduction with the need for revision surgeries and complications in 20% of patients. The important gadget is to highlight the need for long-term follow when talking about results.