Laparoscopic adjustable gastric banding: surgical and radiological approach

The laparoscopically-placed adjustable gastric band (LAGB) is a minimally invasive, adjustable and completely reversible operation. We report 3 years experience. Between May 1998 and January 2001, we operated on a consecutive series of 50 patients (8 male/42 female). Mean age of patients was 37 years (30-48). Mean preoperative BMI was 43 kg/m2 (range 38-55). Mean operative time was 130 minutes (range 75-150), and the conversion rate was 6%. Mean hospital stay was 2.8 days (range 2-10). Postoperatively 7/50 (14%) of patients had dysphagia and subsequently 2 (4%) developed gastric pouch dilatation. 2/50 (4%) had non-fatal pulmonary embolism and 2/50 (4%) developed gastroesophageal reflux. Overall morbidity was 32%. There has been no mortality. 6 weeks postoperatively, patients had adjustment of the band by the radiologists. Follow-up has been up to 30 months. Mean excess weight loss at 6 months was 30% (range 26-35%, N = 50), at 12 months 52% (range 44-55%, N = 42), at 24 months 60% (range 55-65%, N = 14) and at 30 months 62% (range 58-64%, N = 8). 5 patients have reached their ideal body weight. LAGB is safe and effective, even early in the learning curve. The radiologist plays a distinct role. A multi-disciplinary team approach is essential for optimal results. Long-term results are pending.