Skip to main content
Top
Published in: Obesity Surgery 7/2013

Open Access 01-07-2013 | Clinical Research

Five-Year Weight Loss Experience of Outpatients Receiving Laparoscopic Adjustable Gastric Band Surgery

Authors: Chris Cobourn, Mary Ann Chapman, Arlene Ali, John Amrhein

Published in: Obesity Surgery | Issue 7/2013

Login to get access

Abstract

Background

This study evaluated the efficacy and safety of laparoscopic adjustable gastric banding (LAGB) in a large cohort of morbidly obese patients followed for up to 5 years.

Methods

Morbidly obese patients, ≥16 years of age, who underwent LAGB surgery at the Surgical Weight Loss Clinic in Ontario, Canada, between May 2005 and January 2011 were eligible for this retrospective chart review. Electronic files were searched to identify all patients who met the inclusion/exclusion criteria. Demographics, weights at baseline and follow-up visits (up to 60 months following surgery), and post-operative complications were documented. As follow-up visits occurred at unevenly spaced intervals within and across patients, modeling methods were used to more accurately assess mean % weight loss (WL) and % excess weight loss (EWL) over time.

Results

This study included 2,815 patients (82 % female, mean age 43 years, mean baseline BMI 44.6 kg/m2) followed for a mean of 21.8 ± 15.4 months. Complications developed in 238 patients (8.5 %), the most frequent being prolapse/slippage (4.2 %), tubing/access port problems (1.2 %), and explantation (1.2 %). Mean %WL and %EWL progressed continuously over the first 2.5 years post-LAGB, plateauing at 20 and 49 %, respectively, for up to 5 years of follow up. Factors associated with increased weight loss were time since surgery, greater baseline weight (excess weight), older age at time of surgery, and male gender.

Conclusions

Weight loss was maintained for up to 5 years in our population of patients who underwent LAGB for the treatment of morbid obesity.
Literature
2.
go back to reference O'Brien PE. Bariatric surgery: mechanisms, indications and outcomes. J Gastroenterol Hepatol. 2010;25:1358–65.PubMedCrossRef O'Brien PE. Bariatric surgery: mechanisms, indications and outcomes. J Gastroenterol Hepatol. 2010;25:1358–65.PubMedCrossRef
3.
go back to reference O'Brien PE, McPhail T, Chaston TB, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006;16:1032–40.PubMedCrossRef O'Brien PE, McPhail T, Chaston TB, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006;16:1032–40.PubMedCrossRef
4.
go back to reference Cunneen SA. Review of meta-analytic comparisons of bariatric surgery with a focus on laparoscopic adjustable gastric banding. Surg Obes Relat Dis. 2008;4:S47–55.PubMedCrossRef Cunneen SA. Review of meta-analytic comparisons of bariatric surgery with a focus on laparoscopic adjustable gastric banding. Surg Obes Relat Dis. 2008;4:S47–55.PubMedCrossRef
5.
go back to reference Parikh MS, Laker S, Weiner M, et al. Objective comparison of complications resulting from laparoscopic bariatric procedures. J Am Coll Surg. 2006;202:252–61.PubMedCrossRef Parikh MS, Laker S, Weiner M, et al. Objective comparison of complications resulting from laparoscopic bariatric procedures. J Am Coll Surg. 2006;202:252–61.PubMedCrossRef
6.
go back to reference Hinojosa MW, Varela JE, Parikh D, et al. National trends in use and outcome of laparoscopic adjustable gastric banding. Surg Obes Relat Dis. 2008;5:150–5.PubMedCrossRef Hinojosa MW, Varela JE, Parikh D, et al. National trends in use and outcome of laparoscopic adjustable gastric banding. Surg Obes Relat Dis. 2008;5:150–5.PubMedCrossRef
7.
go back to reference Flum DR, Belle SH, King WC, et al. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361:445–54.PubMedCrossRef Flum DR, Belle SH, King WC, et al. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361:445–54.PubMedCrossRef
8.
go back to reference Montgomery KF, Watkins BM, Ahroni JH, et al. Outpatient laparoscopic adjustable gastric banding in super-obese patients. Obes Surg. 2007;17:711–6.PubMedCrossRef Montgomery KF, Watkins BM, Ahroni JH, et al. Outpatient laparoscopic adjustable gastric banding in super-obese patients. Obes Surg. 2007;17:711–6.PubMedCrossRef
9.
go back to reference Sasse KC, Ganser JH, Kozar MD, et al. Outpatient weight loss surgery: initiating a gastric bypass and gastric banding ambulatory weight loss surgery center. Jsls. 2009;13:50–5.PubMed Sasse KC, Ganser JH, Kozar MD, et al. Outpatient weight loss surgery: initiating a gastric bypass and gastric banding ambulatory weight loss surgery center. Jsls. 2009;13:50–5.PubMed
10.
go back to reference Watkins BM, Ahroni JH, Michaelson R, et al. Laparoscopic adjustable gastric banding in an ambulatory surgery center. Surg Obes Relat Dis. 2008;4:S56–62.PubMedCrossRef Watkins BM, Ahroni JH, Michaelson R, et al. Laparoscopic adjustable gastric banding in an ambulatory surgery center. Surg Obes Relat Dis. 2008;4:S56–62.PubMedCrossRef
11.
go back to reference Cobourn C, Mumford D, Chapman MA, et al. Laparoscopic gastric banding is safe in outpatient surgical centers. Obes Surg. 2010;20:415–22.PubMedCrossRef Cobourn C, Mumford D, Chapman MA, et al. Laparoscopic gastric banding is safe in outpatient surgical centers. Obes Surg. 2010;20:415–22.PubMedCrossRef
12.
go back to reference O'Brien P. Is weight loss more successful after gastric bypass than gastric banding for obese patients? Nat Clin Pract Gastroenterol Hepatol. 2009;6:136–7.PubMedCrossRef O'Brien P. Is weight loss more successful after gastric bypass than gastric banding for obese patients? Nat Clin Pract Gastroenterol Hepatol. 2009;6:136–7.PubMedCrossRef
13.
go back to reference Caiazzo R, Arnalsteen L, Pigeyre M, et al. Long-term metabolic outcome and quality of life after laparoscopic adjustable gastric banding in obese patients with type 2 diabetes mellitus or impaired fasting glucose. Br J Surg. 2010;97:884–91.PubMedCrossRef Caiazzo R, Arnalsteen L, Pigeyre M, et al. Long-term metabolic outcome and quality of life after laparoscopic adjustable gastric banding in obese patients with type 2 diabetes mellitus or impaired fasting glucose. Br J Surg. 2010;97:884–91.PubMedCrossRef
14.
go back to reference Garb J, Welch G, Zagarins S, et al. Bariatric surgery for the treatment of morbid obesity: a meta-analysis of weight loss outcomes for laparoscopic adjustable gastric banding and laparoscopic gastric bypass. Obes Surg. 2009;19:1447–55.PubMedCrossRef Garb J, Welch G, Zagarins S, et al. Bariatric surgery for the treatment of morbid obesity: a meta-analysis of weight loss outcomes for laparoscopic adjustable gastric banding and laparoscopic gastric bypass. Obes Surg. 2009;19:1447–55.PubMedCrossRef
15.
go back to reference Himpens J, Cadiere GB, Bazi M, et al. Long-term outcomes of laparoscopic adjustable gastric banding. Arch Surg. 2011;146:802–7.PubMedCrossRef Himpens J, Cadiere GB, Bazi M, et al. Long-term outcomes of laparoscopic adjustable gastric banding. Arch Surg. 2011;146:802–7.PubMedCrossRef
16.
go back to reference Lanthaler M, Aigner F, Kinzl J, et al. Long-term results and complications following adjustable gastric banding. Obes Surg. 2010;20:1078–85.PubMedCrossRef Lanthaler M, Aigner F, Kinzl J, et al. Long-term results and complications following adjustable gastric banding. Obes Surg. 2010;20:1078–85.PubMedCrossRef
17.
go back to reference Ray JB, Ray S. Safety, efficacy, and durability of laparoscopic adjustable gastric banding in a single surgeon U.S. community practice. Surg Obes Relat Dis. 2011;7:140–4.PubMedCrossRef Ray JB, Ray S. Safety, efficacy, and durability of laparoscopic adjustable gastric banding in a single surgeon U.S. community practice. Surg Obes Relat Dis. 2011;7:140–4.PubMedCrossRef
18.
go back to reference Scozzari G, Farinella E, Bonnet G, et al. Laparoscopic adjustable silicone gastric banding vs laparoscopic vertical banded gastroplasty in morbidly obese patients: long-term results of a prospective randomized controlled clinical trial. Obes Surg. 2009;19:1108–15.PubMedCrossRef Scozzari G, Farinella E, Bonnet G, et al. Laparoscopic adjustable silicone gastric banding vs laparoscopic vertical banded gastroplasty in morbidly obese patients: long-term results of a prospective randomized controlled clinical trial. Obes Surg. 2009;19:1108–15.PubMedCrossRef
19.
go back to reference te Riele WW, Boerma D, Wiezer MJ, et al. Long-term results of laparoscopic adjustable gastric banding in patients lost to follow-up. Br J Surg. 2010;97:1535–40.CrossRef te Riele WW, Boerma D, Wiezer MJ, et al. Long-term results of laparoscopic adjustable gastric banding in patients lost to follow-up. Br J Surg. 2010;97:1535–40.CrossRef
20.
go back to reference Colles SL, Dixon JB, Marks P, et al. Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr. 2006;84:304–11.PubMed Colles SL, Dixon JB, Marks P, et al. Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr. 2006;84:304–11.PubMed
21.
22.
go back to reference Verbeke G, Molenberghs G. Linear mixed models for longitudinal data. New York: Springer; 2000. Verbeke G, Molenberghs G. Linear mixed models for longitudinal data. New York: Springer; 2000.
23.
go back to reference Dixon JB, Murphy DK, Segel JE, et al. Impact of laparoscopic adjustable gastric banding on type 2 diabetes. Obes Rev. 2012;13:57–67.PubMedCrossRef Dixon JB, Murphy DK, Segel JE, et al. Impact of laparoscopic adjustable gastric banding on type 2 diabetes. Obes Rev. 2012;13:57–67.PubMedCrossRef
24.
go back to reference Arapis K, Chosidow D, Lehmann M, et al. Long-term results of adjustable gastric banding in a cohort of 186 super-obese patients with a BMI>/= 50 kg/m2. J Visc Surg. 2012;149:e143–52.PubMedCrossRef Arapis K, Chosidow D, Lehmann M, et al. Long-term results of adjustable gastric banding in a cohort of 186 super-obese patients with a BMI>/= 50 kg/m2. J Visc Surg. 2012;149:e143–52.PubMedCrossRef
25.
go back to reference Spivak H, Abdelmelek MF, Beltran OR, et al. Long-term outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in the United States. Surg Endosc. 2012;26:1909–19.PubMedCrossRef Spivak H, Abdelmelek MF, Beltran OR, et al. Long-term outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in the United States. Surg Endosc. 2012;26:1909–19.PubMedCrossRef
26.
go back to reference te Riele WW, Vogten JM, Boerma D, et al. Comparison of weight loss and morbidity after gastric bypass and gastric banding. A single center European experience. Obes Surg. 2008;18:11–6.CrossRef te Riele WW, Vogten JM, Boerma D, et al. Comparison of weight loss and morbidity after gastric bypass and gastric banding. A single center European experience. Obes Surg. 2008;18:11–6.CrossRef
27.
go back to reference Puzziferri N, Nakonezny PA, Livingston EH, et al. Variations of weight loss following gastric bypass and gastric band. Ann Surg. 2008;248:233–42.PubMedCrossRef Puzziferri N, Nakonezny PA, Livingston EH, et al. Variations of weight loss following gastric bypass and gastric band. Ann Surg. 2008;248:233–42.PubMedCrossRef
28.
go back to reference Dixon JB, O'Brien PE, Playfair J, et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA. 2008;299:316–23.PubMedCrossRef Dixon JB, O'Brien PE, Playfair J, et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA. 2008;299:316–23.PubMedCrossRef
29.
go back to reference Dixon JB, O'Brien PE. Health outcomes of severely obese type 2 diabetic subjects 1 year after laparoscopic adjustable gastric banding. Diabetes Care. 2002;25:358–63.PubMedCrossRef Dixon JB, O'Brien PE. Health outcomes of severely obese type 2 diabetic subjects 1 year after laparoscopic adjustable gastric banding. Diabetes Care. 2002;25:358–63.PubMedCrossRef
30.
go back to reference Schauer PR, Burguera B, Ikramuddin S, et al. Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg. 2003;238:467–84. discussion 84–5.PubMed Schauer PR, Burguera B, Ikramuddin S, et al. Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg. 2003;238:467–84. discussion 84–5.PubMed
31.
go back to reference Camastra S, Gastaldelli A, Mari A, et al. Early and longer term effects of gastric bypass surgery on tissue-specific insulin sensitivity and beta cell function in morbidly obese patients with and without type 2 diabetes. Diabetologia. 2011;54:2093–102.PubMedCrossRef Camastra S, Gastaldelli A, Mari A, et al. Early and longer term effects of gastric bypass surgery on tissue-specific insulin sensitivity and beta cell function in morbidly obese patients with and without type 2 diabetes. Diabetologia. 2011;54:2093–102.PubMedCrossRef
32.
go back to reference Nannipieri M, Mari A, Anselmino M, et al. The role of beta-cell function and insulin sensitivity in the remission of type 2 diabetes after gastric bypass surgery. J Clin Endocrinol Metab. 2011;96:E1372–9.PubMedCrossRef Nannipieri M, Mari A, Anselmino M, et al. The role of beta-cell function and insulin sensitivity in the remission of type 2 diabetes after gastric bypass surgery. J Clin Endocrinol Metab. 2011;96:E1372–9.PubMedCrossRef
33.
go back to reference Hall TC, Pellen MG, Sedman PC, et al. Preoperative factors predicting remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass surgery for obesity. Obes Surg. 2010;20:1245–50.PubMedCrossRef Hall TC, Pellen MG, Sedman PC, et al. Preoperative factors predicting remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass surgery for obesity. Obes Surg. 2010;20:1245–50.PubMedCrossRef
34.
go back to reference Dixon JB, Dixon AF, O'Brien PE. Improvements in insulin sensitivity and beta-cell function (HOMA) with weight loss in the severely obese. Homeostatic model assessment. Diabet Med. 2003;20:127–34.PubMedCrossRef Dixon JB, Dixon AF, O'Brien PE. Improvements in insulin sensitivity and beta-cell function (HOMA) with weight loss in the severely obese. Homeostatic model assessment. Diabet Med. 2003;20:127–34.PubMedCrossRef
35.
go back to reference Dixon JB, Chuang LM, Chong K, et al. Predicting the glycemic response to gastric bypass surgery in patients with type 2 diabetes. Diabetes Care 2012; Dixon JB, Chuang LM, Chong K, et al. Predicting the glycemic response to gastric bypass surgery in patients with type 2 diabetes. Diabetes Care 2012;
36.
go back to reference Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.PubMedCrossRef Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.PubMedCrossRef
37.
go back to reference Dixon JB, Straznicky NE, Lambert EA, et al. Surgical approaches to the treatment of obesity. Nat Rev Gastroenterol Hepatol. 2011;8:429–37.PubMedCrossRef Dixon JB, Straznicky NE, Lambert EA, et al. Surgical approaches to the treatment of obesity. Nat Rev Gastroenterol Hepatol. 2011;8:429–37.PubMedCrossRef
38.
go back to reference van de Laar A, de Caluwe L, Dillemans B. Relative outcome measures for bariatric surgery. Evidence against excess weight loss and excess body mass index loss from a series of laparoscopic Roux-en-Y gastric bypass patients. Obes Surg. 2011;21:763–7.PubMedCrossRef van de Laar A, de Caluwe L, Dillemans B. Relative outcome measures for bariatric surgery. Evidence against excess weight loss and excess body mass index loss from a series of laparoscopic Roux-en-Y gastric bypass patients. Obes Surg. 2011;21:763–7.PubMedCrossRef
39.
go back to reference O'Brien PE, Dixon JB, Laurie C, et al. A prospective randomized trial of placement of the laparoscopic adjustable gastric band: comparison of the perigastric and pars flaccida pathways. Obes Surg. 2005;15:820–6.PubMedCrossRef O'Brien PE, Dixon JB, Laurie C, et al. A prospective randomized trial of placement of the laparoscopic adjustable gastric band: comparison of the perigastric and pars flaccida pathways. Obes Surg. 2005;15:820–6.PubMedCrossRef
40.
go back to reference Alhamdani A, Wilson M, Jones T, et al. Laparoscopic adjustable gastric banding: a 10-year single-centre experience of 575 cases with weight loss following surgery. Obes Surg. 2012;22:1029–38.PubMedCrossRef Alhamdani A, Wilson M, Jones T, et al. Laparoscopic adjustable gastric banding: a 10-year single-centre experience of 575 cases with weight loss following surgery. Obes Surg. 2012;22:1029–38.PubMedCrossRef
Metadata
Title
Five-Year Weight Loss Experience of Outpatients Receiving Laparoscopic Adjustable Gastric Band Surgery
Authors
Chris Cobourn
Mary Ann Chapman
Arlene Ali
John Amrhein
Publication date
01-07-2013
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 7/2013
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-013-0881-7

Other articles of this Issue 7/2013

Obesity Surgery 7/2013 Go to the issue