Laparotomic vs laparoscopic lap-band: 4-year results with early and intermediate complications.
BACKGROUND
Adjustable banding is safe, low invasive, and effective for losing weight.


METHODS
69 patients underwent this procedure by laparotomy or laparoscopy.


RESULTS
Patients operated by laparotomy lost more weight than those operated by laparoscopy, but in 4 patients we were forced to re-operate in order to remove the band (3 pouch dilatations and 1 stomach slippage), and in 9 patients a ventral hernia appeared (5 patients repaired). In the laparoscopic cases there were 4 intra-operative gastric perforations, but all were repaired and the band placed at the same time (3 conversions to open), causing an increased post-operative hospital stay. There was a lower limb deep venous thromboembolism, which was followed by fatal pulmonary embolism (although the patient had been given heparin and had been treated with elastocompression and mobilization 2 hours after surgery). The band eroded in one patient. Weight losses in these morbidly obese patients were satisfactory at 2 years and maintained beyond 3 years.


CONCLUSIONS
Laparoscopic adjustable banding is an efficient, generally safe procedure.
De Luca
M
M
General and Oncological Surgery, University Federico, Naples, Italy.
de Werra
C
C
Formato
A
A
Formisano
C
C
Loffredo
A
A
Naddeo
M
M
Forestieri
P
P
D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery; D011183:Postoperative Complications; D012086:Reoperation; D016896:Treatment Outcome