Adjustable gastric banding: 5-year experience

Background: From 1993 to 1999, 172 patients underwent adjustable silicone g astric banding (ASGB) or laparoscopic adjustable silicone gastric banding ( LASGB). In 109 patients the adjustable band was placed via laparoscopy; in the other patients it was placed via laparotomy (prelaparoscopic era, conve rsions from other bariatric operations, conversions for laparoscopic failur e). The conversion rate from laparoscopy to laparotomy was 9.3%, occurring in the early part of our experience, Methods: Mean age was 37.9 years, weight 135 +/- 14.8 kg (82-218) and BMI 4 6.3 +/- 5.4 (35.1-69.5). All patients had multiple band adjustments, tempor ary antisecretive, electrolyte and vitamin therapy, and follow-upper routin e. Results: Weight loss at 3 years was 30.2%; mean percent loss of excess weig ht was 62.5%. There was no mortality, The most important technical complica tions were: gastric pouch dilatation that required band replacement or remo val (5.8 %); mild gastric pouch dilatation reversible with adequate dietary and pharmacological treatment (4.6%); intraoperative gastric perforation ( 2.3%); band migration (0.6%). The band was removed in 2.3%, with conversion to another bariatric procedure in 1.1%. Conclusions: Results have been satisfactory thus far.