Laparoscopic adjustable gastric band: how to reduce the early morbidity.
BACKGROUND
Laparoscopic adjustable gastric band insertion is a safe weight reduction procedure, but serious complications can develop. The aim of this study was to evaluate our technique in preventing early band complications.


METHODS
Patients were given the choice of procedure according to body mass index, the presence of diabetes, and preference. Weight loss data were not considered, as our aim was to evaluate the morbidity of band surgery using a specific technique. A pars flaccida approach and plication technique were used for all patients. Postoperative follow-up was provided at 1 month, 2 months, and every 3 months for the first year and then yearly for a further 2 years. Thereafter, general practitioners referred patients if late complications arose.


RESULTS
From January 2007 to August 2011, 1149 patients (245 men [21.32%], 904 women [78.67%]) underwent laparoscopic adjustable gastric band insertion under the care of a single bariatric surgeon. Patients were hospitalized for 1 night only unless they developed early complications. The primary and secondary outcomes were major and minor band complications, respectively. Patients' age range was 18 to 64 years (mean, 44 years). Body mass index ranged from 33 to 62 kg/m2 (mean, 42 kg/m2). There were 2 band erosions (0.17%), 6 cases of band prolapse (0.52%), 4 port problems (0.34%), 1 band leak (0.08%), 3 tight bands (0.26%), 2 port infections (0.17%), and no deaths. Five procedures (0.43%) were abandoned and excluded from this study, and 1 (0.17%) was converted to minilaparotomy to control abdominal wall bleeding. The duration of follow-up ranged from 16 to 60 months.


CONCLUSIONS
A combined pars flaccida and plication technique is associated with a low early complication rate.
Bariatric Unit, General Surgery Department, Princess Royal University Hospital, Orpington, Greater London, United Kingdom.
Abdulzahra A
AA
Hussain
Bariatric Unit, University College London Hospitals, Greater London, United Kingdom.
Jacqueline
J
Nicholls
Bariatric Unit, General Surgery Department, Princess Royal University Hospital, Orpington, Greater London, United Kingdom.
Shamsi S
SS
El-Hasani
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D015431:Weight Loss; D055815:Young Adult
Body mass index; Laparoscopic adjustable gastric band; pars flaccida