Five-year results of laparoscopic vertical banded gastroplasty in the treatment of massive obesity.
BACKGROUND
Laparoscopic surgery appears to offer rapid recovery and low postoperative morbidity. The aim of the present study was to assess the outcome of laparoscopic vertical banded gastroplasty (LVBG) in 154 obese patients with a follow-up of 12-60 months.


METHODS
154 massively obese patients (132 female) with a mean +/- SEM body mass index (BMI) of 43.4 +/- 0.6 kg/m2 were followed prospectively for an average of 31.7 +/- 1.4 months. LVBG was performed using 5 trocars placed in a standard fashion for laparoscopic upper gastrointestinal surgery. A 4-row stapler was used for the vertical staple-line and a stretched polytetrafluoroethylene (Gore-tex) band was used to reinforce the outlet. After the first 67 cases, the procedure was altered so that a 5-cm length was marked on the band.


RESULTS
Conversion to open surgery was performed in 33 cases. All patients lost weight. At 60 months follow-up, the postoperative weight was similar in the open and laparoscopic group.The subjects where 5 cm length was marked on the band had a significantly better weight loss at 36 months (30.4 +/- 1.2). Both early (< 1 month postoperative) and late (> 1 month postoperative) complications were more common in the group converted to open surgery. Postoperative stay was shorter in the laparoscopic group.


CONCLUSIONS
LVBG can be performed safely and results in shorter postoperative stay than open VBG. With adherence to surgical technique (5-cm band circumference), weight-loss is maintained at an adequate level. Complications after LVBG do not exceed open VBG.
Magnusson
Mårten
M
Division of Surgery, Karolinska Institutet, Danderyd Hospital, SE 182 88 Stockholm, Sweden.
Freedman
Jacob
J
Jonas
Eduard
E
Stockeld
Dag
D
Granström
Lars
L
Näslund
Erik
E
D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery; D017792:Surgical Stapling; D013529:Surgical Wound Dehiscence; D016896:Treatment Outcome; D015431:Weight Loss