Lap-Band Weight Loss Surgery Study
Lap-Band Surgery Study Introduction
Laparoscopic adjustable gastric banding was first introduced in the early
1990s as a potentially safe, controllable, and reversible method for achieving
significant weight loss in the severely obese. The Bioenterics Lap-Band®
system is the device most commonly used. After 10 years of experience
in treating more than 100,000 patients with the Lap-Band, it is timely
for us to review the outcomes.
Lap-Band Surgery Study Background
Lap-Band placement has proved to be a very safe procedure with a mortality
rate in the published reports of 1 in 2000, only 10 percent of the published
mortality rate of gastric bypass. The early complication rate has been
very low, but late complications of prolapse or erosions have been more
frequent, particularly during the early experience.
Lap-Band Surgery Study Methods
Data for the review are derived from the experience of our unit in the
treatment of 1250 patients to date, from an independent systematic review
of the published literature up to September 2001, and from major studies
published after the date of closure of the systematic review.
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Lap-Band Surgery Study Results
Weight is lost during the first 2 to 3 years after surgery. The
systematic review reports 56 percent excess weight loss (EWL) at
5 years (three reports). In comparison, Roux-en-Y gastric bypass
(RYGB) is reported to have achieved 59 percent EWL at 5 years (four
reports). Major improvements in comorbid conditions have been reported
in association with weight loss after Lap-Band placement. Most importantly,
type 2 diabetes is usually cured, and insulin resistance and reduced
pancreatic -cell function are reversed. Gastroesophageal reflux,
obstructive sleep apnea, and depression are other diseases in which
marked improvement is noted. Quality-of-life scores return to normal
values.
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Lap-Band Surgery Study Conclusion
Lap-Band placement is proving to be safe and effective. In view of the
attributes of adjustability, safe laparoscopic placement, and reversibility,
it should be considered the optimal initial approach for the control of
obesity and its comorbid conditions.
Source: Journal of Laparoendoscopic &
Advanced Surgical Techniques, 1 August 2003. O'Brien P.E.[1]; Dixon J.B.[1]
Monash University Department of Surgery.
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