Adjustable silicone gastric banding: can We continue the original technique of Kuzmak?
BACKGROUND
Kuzmak developed a horizontal gastroplasty for morbid obesity using his adjustable silicone gastric banding (ASGB). The aim of this study was to evaluate the efficiency at weight loss, early and late morbidity and mortality.


METHODS
The records of 44 patients (mean age 36 years) were reviewed. The indication for ASGB was a BMI >40 (group A = 37 patients) or a BMI between 35 and 40 with obesity-related morbidity (group B = 7 patients). The mean preoperative BMI was 44 (+/-5). The paired t test was used to evaluate the BMI.


RESULTS
Early complications occurred in 5 patients: splenic injury (n = 1), aspiration pneumonia (n = 1), wound infection (n = 1), gastric perforation (n = 2); mortality was 2%. Late complications occurred in 19 patients: 17 patients (39%) had a functional stenosis with pouch dilatation (FSPD) and 6 patients had an injection port leakage (14%). At the 1-year follow-up, the mean BMI (of the 39 patients available) was 30 (+/-5) and remained stable. At 36 months, 54% of group A and 100% of group B had a BMI <30.


CONCLUSIONS
The original technique of Kuzmak is effective to lose weight. However the technique must be adjusted in order to decrease the unacceptable high incidence of FSPD.
Eerten
P V
PV
Department of Surgery, Free University Hospital, Amsterdam, The Netherlands. pv.van.eerten@hetnet.nl
Hunfeld
M A
MA
Tuinebreijer
W E
WE
Cuesta
M A
MA
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D017060:Patient Satisfaction; D012828:Silicones; D016896:Treatment Outcome; D015431:Weight Loss
D012828:Silicones