Laparoscopic adjustable gastric banding for severe obesity

Background: Morbid obesity is an increasingly common condition with serious associated morbidity and decreased life expectancy. The only treatment with long-term efficacy for this condition is surgical intervention. Laparoscopic adjustable gastric banding (LAGB) is a procedure increasingly performed in European centres and recently approved by the FDA in USA. This article reviews its effectiveness and complications. Methods: A literature search identified relevant articles. Results: LAGB results in approximately 60% (43-78%) excess weight loss at 3 years with improvement in co-morbidities, with perioperative mortality <0.5%. Potential complications include prolapse or pouch dilatation, and port-related complications. Less common complications are intra-operative gastric perforation and band erosion. Rate of reoperation varies greatly between series, and is usually needed for band repositioning or port-related procedures, many of the latter performed under local anesthesia. Conclusion: The available data demonstrate that LAGB is a safe bariatric procedure, and is effective in the short- and medium-term. Results of long-term follow-up are awaited.