title: Laparoscopic adjustable gastric band: 4-year experience and learning curve.
abstract: OBJECTIVE
  Laparoscopic adjustable gastric banding has become the most popular procedure for the treatment of morbid obesity in Europe. The objectives of this series are to report the results of the 4-year experience of a single surgeon and to define the learning curve.
  
  
  METHODS
  A retrospective review of 156 patients who underwent laparoscopic adjustable gastric banding between October 2006 and May 2010 was performed. Patients were separated into 3 groups: group 1 comprised the first 50 patients; group 2 comprised the second 50 patients; and group 3 comprised the last group of patients, with a total of 56 patients.
  
  
  RESULTS
  The male-to-female ratio was 1:4 (33 male and 133 female patients). The mean age was 38 years (range, 17-62 years). The mean preoperative body mass index was 44.9 kg/m(2). The mean percent excess weight loss was 41.7% at the 1-year follow-up visit (153 patients, 98%), 49.7% at the 2-year follow-up visit (147 patients, 94%), and 50.2% at the 3-year follow-up visit (127 patients, 81%). The overall complication rate and major complication rate were 15.4% and 3.2%, respectively. There were no deaths. Percent excess weight loss, length of hospitalization (in days), and complication rates were compared among the 3 groups. No significant differences were noted among the groups except in the number of complications (P < .001), but all data were clearly improved in groups 2 and 3.
  
  
  CONCLUSIONS
  The analyses in this study have documented one more time that laparoscopic adjustable gastric banding is an effective procedure for the treatment of morbid obesity, achieving >50% excess weight loss at 3 years. It is a procedure with certain complications even when performed by a surgeon with previous experience in laparoscopic surgery. According to our subset analysis, the learning curve is at least 50 procedures.
authors.affiliation: First Department of Surgery and Transplant Unit, Evangelismos General Hospital, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Papadimitriou
authors.affiliation: First Department of Surgery and Transplant Unit, Evangelismos General Hospital, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Vardas
authors.affiliation: First Department of Surgery and Transplant Unit, Evangelismos General Hospital, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Alfaras
authors.affiliation: First Department of Surgery and Transplant Unit, Evangelismos General Hospital, Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Alfaras
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D015431:Weight Loss; D055815:Young Adult
keywords: Complications; Laparoscopic adjustable gastric band; Learning curve; Morbid obesity
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