A new adjustable gastric band was developed, consisting of a silicone
balloon connected to a subcutaneous port in a closed system. The stoma
diameter can be regulated within an extensive range (0-40 mm). The di
ameter is adjusted individually for each patient and weight loss can t
herefore be controlled and optimized. We evaluated the application of
this new gastric banding procedure in terms of technical feasibility,
complication rate and weight loss, and also the relationship between w
eight loss and pouch volume. Between January 1987 and April 1990 two p
reliminary studies of 18 and 24 patients respectively were carried out
. In the first group there were technical problems resulting in insuff
icient weight loss. We therefore changed the procedure. In the second
group the system thereafter worked as expected. In the second group me
an preoperative weight was 132 kg, mean excess weight 60 kg, and mean
BMI 45. The mean follow-up was in 21 months. At follow-up mean weight
was 91 kg, mean weight loss 41 kg, and mean BMI 31. The mean postopera
tive stay was 6.0 days. Pouch volume and stoma diameter were followed
by regular endoscopy. There was a distinct relationship between pouch
volume and weight loss-the smaller the volume the greater the weight l
oss.