title: The Pattern of Adjustments after Laparoscopic Adjustable Gastric Band.
abstract: BACKGROUND
  The success of laparoscopic adjustable gastric band (LAGB) is dependent on gradual adjustments over time. The aim of this study is to describe that pattern of LAGB adjustments that are required after surgery.
  
  
  METHODS
  A non-randomized observational study of consecutive LAGB from a single practise. Patients were sourced from a prospective database. Details of each LAGB adjustment were recorded along with weight loss and complications.
  
  
  RESULTS
  There were 125 consecutive LAGB between March 2009 and September 2011 (mean age 46.6 ± 11.9 years; 113 female, BMI 42.1 ± 5.9 kg/m(2)). The mean %EBWL was 41.4 ± 19.1 % at 2 years. There was a total of 746 band adjustments with mean 7.1 ± 4.4 per patient. Approximately, a third of patients (34 %) reached optimal volume within 6 months but 49 patients (39 %) still required adjustments beyond a year. Weight loss was maximal prior to the first adjustment (41 % of mean total weight loss). The rate of weight loss decreased down to 1-3 %EBWL between later fills despite repeated increases in band volume. Urgent deflations were required in 63 patients with 24 of these patients having multiple overfills. There were two patients who had gastric prolapse but no other LAGB-related complications occurred in the first 2 years after surgery.
  
  
  CONCLUSIONS
  LAGB requires a considerable postoperative commitment that may take several months. Overfills are common and may be the result of a false perception that tightening the band will hasten weight loss.
authors.affiliation: Academic Department of Surgery, Faculty of Medicine and Health Sciences, University of Otago Christchurch, Christchurch, New Zealand. richard.flint@otago.ac.nz.|Department of General Surgery, Christchurch Hospital, Christchurch, New Zealand. richard.flint@otago.ac.nz.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Flint
authors.affiliation: Department of General Surgery, Christchurch Hospital, Christchurch, New Zealand.
authors.forename: Grant
authors.initials: G
authors.lastname: Coulter
authors.affiliation: Department of General Surgery, Christchurch Hospital, Christchurch, New Zealand.
authors.forename: Ross
authors.initials: R
authors.lastname: Roberts
mesh_terms: D000328:Adult; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D011184:Postoperative Period; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015431:Weight Loss / Q000502:physiology
keywords: Laparoscopic adjustable gastric band; Obesity
references.citation: Obes Surg. 2003 Feb;13(1):121-7
references.pmid: 12630626
references.citation: Am J Surg. 2002 Dec;184(6B):38S-41S
references.pmid: 12527349
references.citation: Obes Surg. 2002 Jun;12(3):380-4
references.pmid: 12082892
references.citation: Am J Surg. 2002 Dec;184(6B):46S-50S
references.pmid: 12527351
references.citation: Ann Surg. 2009 Oct;250(4):631-41
references.pmid: 19730234
references.citation: Ann Surg. 2011 Sep;254(3):410-20; discussion 420-2
references.pmid: 21865942
references.citation: Obes Surg. 2006 Nov;16(11):1450-6
references.pmid: 17132410
references.citation: Surg Obes Relat Dis. 2011 Jan-Feb;7(1):74-9
references.pmid: 20947444
references.citation: Obes Surg. 2003 Apr;13(2):159-60
references.pmid: 12760387
references.citation: Obes Surg. 2009 Nov;19(11):1508-14
references.pmid: 19730960
references.citation: Obes Surg. 2002 Oct;12(5):652-60
references.pmid: 12448387
references.citation: Ann Surg. 2001 Jun;233(6):809-18
references.pmid: 11371739
references.citation: N Engl J Med. 2009 Jul 30;361(5):445-54
references.pmid: 19641201
references.citation: Obes Surg. 2008 Sep;18(9):1104-8
references.pmid: 18431612
references.citation: Obes Surg. 2005 Jun-Jul;15(6):820-6
references.pmid: 15978154
references.citation: ANZ J Surg. 2007 Jul;77(7):550-2
references.pmid: 17610691
references.citation: Am J Surg. 2002 Dec;184(6B):26S-30S
references.pmid: 12527347