Laparoscopic gastric banding: Safe and modestly successful

Background: Obesity is an increasing problem in Australia. It is defined as a body mass index (BMI) >30 kg/m(2). It is associated with a number of significant medical conditions, as well as psychological morbidity related to poor body image and the social stigma of obesity. Conservative management is rarely successful in patients with morbid obesity and bariatric surgery is an alternative more likely to produce sustained results. Methods: To compare the initial results of the Lap-Band (Inamed Health, Santa Barbara, CA, USA) procedure when performed by experienced general laparoscopic surgeons, new to the procedure and those achieved by dedicated bariatric practitioners. Results: The results of the present study showed forty-seven per cent excess weight lost at 2 years, 49% excess BMI lost at 2 years. Reoperation rate for band removal, prolapse/slippage was 25.3%. Conclusions: Acceptable results with Lap-Band are technically achievable by experienced laparoscopic surgeons with a low morbidity and mortality. The results of the present study are inferior to those reported by dedicated bariatric practices who have performed large numbers of this operation. The rate of band slippage was unacceptably high and there was a significant problem with patients being lost to follow up. Possible reasons for this are discussed.