Laparoscopic gastric banding: a prospective, randomized study comparing the Lapband and the SAGB: early results.
OBJECTIVE
The objective of this study was to evaluate the results of laparoscopic gastric banding using 2 different bands (the Lapband [Bioenterics, Carpinteria, CA] and the SAGB [Swedish Adjustable Gastric Band; Obtech Medical, 6310 Zug, Switzerland]) in terms of weight loss and correction of comorbidities, short-and long-term complications, and improvement of quality of life in morbidly obese patients


BACKGROUND
During the past 10 years, gastric banding has become 1 of the most common bariatric procedures, at least in Europe and Australia. Weight loss can be excellent, but it is not sufficient in a significant proportion of patients, and a number of long-term complications can develop. We hypothesized that the type of band could be of importance in the outcome.


METHODS
One hundred eighty morbidly obese patients were randomly assigned to receive the Lapband or the SAGB. All the procedures were performed by the same surgeon. The primary end point was weight loss, and secondary end points were correction of comorbidities, early- and long-term complications, importance of food restriction, and improvement of quality of life.


RESULTS
Initial weight loss was faster in the Lapband group, but weight loss was eventually identical in the 2 groups. There was a trend toward more early band-related complications and more band infections with the SAGB, but the study had limited power in that respect. Correction of comorbidities, food restriction, long-term complications, and improvement of quality of life were identical. Only 55% to 60% of the patients achieved an excess weight loss of at least 50% in both groups. There was no difference in the incidence of long-term complications.


CONCLUSIONS
Gastric banding can be performed safely with the Lapband or the SAGB with similar short- and midterm results with respect to weight loss and morbidity. Only 50% to 60% of the patients will achieve sufficient weight loss, and close to 10% at least will develop severe long-term complications.
Suter
Michel
M
Department of Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. michelsuter@netplus.ch
Giusti
Vittorio
V
Worreth
Marc
M
Héraief
Eric
E
Calmes
Jean-Marie
JM
D000328:Adult; D000368:Aged; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010348:Patient Care Team; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D012086:Reoperation; D016896:Treatment Outcome; D015431:Weight Loss