Long-term data indicate a progressive loss in efficacy of adjustable silicone gastric banding for the surgical treatment of morbid obesity.
BACKGROUND
Many short-term follow-up reports on the efficacy of the adjustable silicone gastric band (ASGB) and its modification for laparoscopic insertion (Lap-Band) for the surgical treatment of morbid obesity have been reported in the surgical literature. However, long-term studies are lacking.


METHODS
Between March 17, 1992, and January 7, 1997, 45 females and 17 males consecutively entered this prospective study. Forty ASGB and 22 Lap-Band were implanted. Mean age was 34 years (range 19-51); mean height was 171 cm (range 152-190); mean weight was 145 kg (range 100-214). Weight loss and adverse events associated with the device were observed over time.


RESULTS
There was no operative mortality. Thirty intra-abdominal reoperations were necessary to correct complications related to the implanted ASGB and the Lap-Band. In the ASGB cohort, the body mass index (BMI) decreased from 50 to 36 over a 3-year period and then increased to 44 at 8 years after operation. In the Lap-Band cohort the BMI decreased from 47 to 40 at 1 year and then increased to 43 at 6 years after operation. Twenty-seven implantable devices (18 ASGB, 9 Lap-Band) have been removed to date.


CONCLUSIONS
The results of this study do not support the use of ASGB devices for the surgical treatment of morbid obesity. The Lap-Band is less effective than ASGB.
Doherty
Cornelius
C
Department of Surgery, College of Medicine, University of Iowa, Iowa City, Iowa 52242-1086, USA.
Maher
James W
JW
Heitshusen
Debra S
DS
D000328:Adult; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012449:Safety; D012828:Silicones; D013997:Time Factors; D015431:Weight Loss
D012828:Silicones