Laparoscopic gastric banding for morbid obesity - Surgical outcome in 335 cases

Background: Morbid obesity occurs in 2-5% of the population of Europe, Aust ralia, and the United States and is becoming more common. Open surgical tec hniques, such as vertical banded gastroplasty and other divisional procedur es in the stomach, have led to long-term weight reduction as well as an ame lioration of the attendant medical problems in approximately two-thirds of patients. Materials and methods: A total of 335 patients with a median age of 41 year s underwent gastric banding. We emphasized the need for long-term maintenan ce and follow-up. The indications for surgery comprised a body mass index > 35, a stated desire to undergo the procedure, and a full understanding of a ll possible complications. Results: All patients have needed band adjustments of 1-4 mi over the cours e of their follow-up. No patient had increased his or her weight during the follow-up, and only three patients have not enjoyed sustained weight loss. Conclusions: Laparoscopic gastric banding has much to recommend it, Certain ly in the short term, its results in terms of effectiveness of weight loss are at least as good as those of any open procedure. Longer follow-up will show whether this weight loss is maintainable. The procedure is technically demanding, and the major prerequisite of satisfactory performance of this surgery is laparoscopic experience.