title: Laparoscopic adjustable gastric banding: early experience in 400 consecutive patients in the USA.
abstract: BACKGROUND
  Early experience with 400 consecutive patients who underwent laparoscopic adjustable gastric banding (LAGB) is reported.
  
  
  METHODS
  From Nov 2002 to Aug 2004, prospective data were collected on 400 consecutive LAGB patients and evaluated retrospectively.
  
  
  RESULTS
  There were 354 (88.5%) females and 46 males (11.5%), with mean age 43.6 years and mean BMI 46.2 kg/m2. For outpatients (freestanding ambulatory surgery center), mean OR time was 55.4 min in 208 patients (52%), compared to mean inpatient OR time of 70.5 min in 192 patients. Inpatients had a higher BMI (48.2 +/- 9.3 SD) than outpatients (43.9 +/- 5.7 SD) (P<0.0001). Complications occurred in 35 patients (8.8%). These consisted of 9 slipped bands (2.3%) that were surgically repositioned, 6 port problems (1.5%) that were successfully repaired, 17 patients with temporary stoma occlusion (4.3%) that spontaneously resolved, and 2 bowel perforations (0.5%) that required surgical repair and band removal. One patient died of pneumonia 2 weeks after an uneventful procedure. Average 1-year percent excess weight loss (%EWL) in 138 patients was 48.2%. Patients who had < or =50 kg initial excess weight (n=37, 27%) had a significantly higher %EWL (55.2%) at 1 year than patients who had >50 kg initial excess weight (P=0.0011).
  
  
  CONCLUSIONS
  LAGB has been safe and effective thus far for the surgical treatment of morbid obesity, and can be performed as an outpatient in select patients.
authors.affiliation: Northwest Weight Loss Surgery, Kirkland, WA 98034, USA. DrWatkins@NWWLS.com
authors.forename: Brad M
authors.initials: BM
authors.lastname: Watkins
authors.forename: Kevin F
authors.initials: KF
authors.lastname: Montgomery
authors.forename: Jessie H
authors.initials: JH
authors.lastname: Ahroni
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis* / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States; D015431:Weight Loss