Laparoscopic gastroplasty for morbid obesity: prospective study of 300 cases

Study aim: Laparoscopic gastric banding for morbid obesity is noninvasive a nd reversible. The aim of this prospective study was to report the prelimin ary results of this procedure in the first 300 patients. Patients and methods: From April 1997 to January 2000, 300 patients were la paroscopically operated for severe obesity: 266 women, 34 men, with a mean age of 40.1 years (range: 16-66). The mean preoperative weight was 118 kg ( range: 85-195) and the mean body mass index (BMI) was 43.6 kg/m(2) (range: 35.1-65.8). This is a recent and complete series with a mean follow-up of 1 0 months (range: 3-31). The primary endpoint was excessive weight loss (EWL ) and the secondary endpoints were tolerance and morbidity. Results: There were no postoperative deaths. The mean operating time was 12 9 minutes (range: 50-380). A conversion to laparotomy was necessary in 11 p atients. The mean hospital stay was 4.76 days (range: 3-42). There were 29 complications (9.6%), 16 among the first 50 procedures: 14 patients underwe nt an abdominal reoperation (2 perforations, 3 early slippages, 7 late slip pages, 2 incisional hernias) 6 had respiratory complications with 2 ARDS an d 9 developed a complication related to the port. At one year, BMI decrease d from 43.6 to 33.7 kg/m(2) and EWL reached 44.2%; 80% of the patients lost 60% of their excess weight. Conclusion: Our experience is encouraging with an acceptable complication r ate (5%) after 50 procedures. Slippage remains the main reason for close su rveillance. Half of the excess weight can be comfortably lost in one year w hen the whole medical and surgical staff provide for each patient. (C) 2001 Editions scientifiques et medicales Elsevier SAS.