Laparoscopic Italian experience with the Lap-Band (R)

Background: An increasing number of surgeons with different levels of exper ience with laparoscopic surgery and open obesity surgery have started to pe rform laparoscopic implantation of the Lap-Band(R). Methods: An electronic patient data sheet was created and was mailed and e- mailed to all surgeons performing laparoscopic adjustable silicone gastric banding (LASGB) in Italy. Patients were recruited since January 1996. Data on 1,265 Lap-Band System(R) operated patients (258 M / 1,007 F; mean BMI 44 .1, range 27.0-78.1; mean age 38, range 17-74 years) were collected from 23 surgeons performing this operation. Results: Intra-operative mortality was absent. Post-operative mortality was 0.55% (7 patients) for causes not specifically related to LASGB implantati on. The laparotomic conversion rate was 1.7% (22 patients). LASGB related c omplications occured in. 143 patients (11.3%). Pouch dilatation was diagnos ed in 65 (5.2%), and 28 (2.2%) of these underwent re-operation. Band erosio n was observed in 24 patients (1.9%). Port or connecting tube-port complica tions occurred in 54 patients (4.2%), 12 of whom required revision under ge neral anesthesia. Followup was obtained at 6, 12, 18, 24, 36 and 48 months, and mean BMI was respectively 38.4, 35.1,33.1, 30.2, 32.1 and 31.5. The pe rcentage of patients observed at each follow-up was >60%. There was no intr aoperative mortality and no complication-related mortality, with acceptable weight loss. Conclusion: The LASGB operation is safe and effective, and deserves wider u se for treatment of morbid obesity.