Results and complications of laparoscopic adjustable gastric banding: An early and intermediate experience

Background: Laparoscopic adjustable silicone gastric banding (LASGB) has be en performed as the initial procedure for weight reduction in the authors' institution for the past 22 months. The efficacy and safety of the procedur e were studied. Methods: Patients were followed up prospectively during the perioperative a nd long-term course and for complications. Results: 391 patients, aged 16-72 years, with a mean body mass index (BMI) of 43.1 (range 33-66) were operated on. The laparoscopic procedure was comp leted in all but four. The mean operative time was 78 min (range 36-165), a nd the mean postoperative hospital stay was 1.2 days (range 1-8). There wer e four (1%) intraoperative complications: pneumothorax in one patient, blee ding in two patients, and injury to the stomach in one. Early postoperative complications were subphrenic abscess in two patients and band malposition in five. Of the patients operated on, 356 (91%) were available for follow- up. Over an average follow-up period of 13 months (range 1-22), band slippa ge occurred in 16 patients (4.1%), resistant port infection in 1, and longs tanding pain in the port area in 9. There were 2 cases of port migration. A total of 26 (6.4%) reoperations were performed: early band repositioning ( 5), bleeding port site (1), late band repositioning (13), band removal(5), and local relocation of the port (2). All abdominal operations were perform ed laparoscopically. During the 18-month follow-up, the average BMI dropped from 43.1 to 29.8. Conclusion: LASGB is a safe procedure, with low early complication rates. M ost reoperations may be performed laparoscopically, with subsequent low mor bidity and short hospitalizations. On intermediate-term follow-up it seems to be an effective bariatric procedure.