Our experience with 250 laparoscopic adjustable silicone gastric bandings.
BACKGROUND
In 1999, after having performed more than 2500 open bariatric surgery procedures, we began to conduct the laparoscopic adjustable silicone gastric banding (LASGB) procedure. The purpose of this report is to present the results of our first 250 operations using this technique.


METHODS
The 250 patients included 212 females and 38 males. The mean age was 36 years (range, 16-62). The mean BMI was 44 (range, 35-76). Patients were selected in accordance with standard criteria. The mean follow-up time was 18 months (range, 3-24).


RESULTS
Two hundred and forty procedures were completed by laparoscopy; conversion to open surgery was required in 10 cases. The mean operating time was 50 min (range, 20-145). There was no mortality. Perioperative complications included two cases of gastric perforation. Late complications included 13 cases of band slippage (5%), of which three involved penetration to the stomach, five cases of port disconnection (2%), and four cases of port site infection (1.5%). The mean weight loss at 12 months was 70% of the original excess weight.


CONCLUSIONS
Most patients prefer laparoscopy as the surgical technique in the treatment of morbid obesity. Our initial experience with 250 operations confirms that this approach is as good as open surgery. The long learning curve is steep, requiring at least 100 cases to guarantee low complication rates.
Dukhno
O
O
Department of Surgery B, Soroka University Medical Center, and the Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. dukhnoo@doctor.com
Ovnat
A
A
Levy
I
I
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012826:Silicone Elastomers / Q000627:therapeutic use*; D016896:Treatment Outcome
D012826:Silicone Elastomers