title: Laparoscopic adjustable gastric banding versus laparoscopic adjustable gastric banding with gastric plication: midterm outcomes in terms of weight loss and short term complications.
abstract: BACKGROUND
  Laparoscopic adjustable gastric banding (LAGB) is a safe procedure with variable outcomes and large standard deviations. LAGB with gastric plication (LAGBP) is a new restrictive procedure that combines the lap band with gastric plication. This procedure, with its mechanism being below the band anatomically, should augment the weaknesses of the lap band: slips and inadequate weight loss.
  
  
  OBJECTIVE
  Compare the weight loss results and complication rates between the LAGB and LAGBP.
  
  
  METHODS
  Private practice.
  
  
  METHODS
  Data was analyzed data from 120 patients retrospectively from 2 surgeons at a single private institution. Seventy-six patients underwent LAGB, and 44 other patients underwent LAGBP between February 2011 and July 2013. All 120 patients are beyond the 1-year postoperative mark and 110 patients are beyond the 2-year postoperative mark. A subset analysis was performed comparing data from both procedures to evaluate weight loss and complications.
  
  
  RESULTS
  There were no significant differences between preoperative age, weight, and body mass index between the patients who underwent either procedure. We had 47.4% and 52.3% follow-up at 1 year for LAGB and LAGBP, respectively, with 91.5% and 92.3% follow-up at 2 year for LAGB and LAGBP, respectively. Complications were low with LAGBP; however, it was not statistically significant (P = .54). The LAGBP had a greater percent excess weight loss, percent total weight loss, and percent excess body mass index lost compared with the LAGB at 3, 6, 9, 12, and 24 months, and these differences were statistically significant. Mean percent excess weight loss for LAGB and LAGBP was 28.3% and 34.5% (P<.05) at 1 year and 32.1% and 39.2% (P<.05) at 2 years, respectively.
  
  
  CONCLUSIONS
  LAGBP is a safe, feasible, and reproducible bariatric procedure. The LAGBP performs significantly better than the LAGB for weight loss. The complication and revision rates were slightly higher with LAGB than LAGBP. However, it was not statistically significant.
authors.affiliation: Bariatric Medicine Institute, Salt Lake City, Utah.
authors.forename: Amit
authors.initials: A
authors.lastname: Surve
authors.affiliation: Bariatric Medicine Institute, Salt Lake City, Utah.
authors.forename: Hinali
authors.initials: H
authors.lastname: Zaveri
authors.affiliation: Bariatric Medicine Institute, Salt Lake City, Utah. Electronic address: drdanielcottam@yahoo.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Cottam
authors.affiliation: Bariatric Medicine Institute, Salt Lake City, Utah.
authors.forename: Christina
authors.initials: C
authors.lastname: Richards
authors.affiliation: Bariatric Medicine Institute, Salt Lake City, Utah.
authors.forename: Samuel
authors.initials: S
authors.lastname: Cottam
authors.affiliation: Bariatric Medicine Institute, Salt Lake City, Utah.
authors.forename: Austin
authors.initials: A
authors.lastname: Cottam
mesh_terms: D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D061646:Operative Time; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
keywords: Band slippage; Gastric Band; Gastric plication; LAGB; LAGBP; Weight loss