Adjustable Silicon Gastric Banding (ASGB, Bioenterics) and Swedish Adjustable Gastric Banding (SAGB, Obtech) in the treatment of morbid obesity

Introduction: Two different adjustable silicone gastric bandings were laparoscopically applied and compared regarding per- and postoperative complications and successful weight loss. Patients and methods: A total of 120 consecutive patients received a laparoscopic adjustable gastric banding and were prospectively documented. In the learning phase (LP) 50 patients were treated with an Adjustable Silicone Gastric Banding (ASGB, Bioenterics) using an intragastric balloon calibration technique according to Belachew. Group I (n = 29) received the same band using a surgical technique with tunneling behind the oesophagus towards His' angle, while the second group (n = 41) received a Swedish Adjustable Gastric Banding (SAGB), using the same technique as in group I. A BMI of > 35, complications secondary to obesity and failed diets were the indication for the operation. Thirty patients were male, 90 female, with a mean age of 37 years (18-60). Results: In the LP 8 patients had to be reoperated (16%) for band slippage and/or pouch dilatation, in group I 6 (19 %) and in group II 1 (3 %) (P = 0.02, II vs I). The mean hospital stay was 3.7 +/- 0.5, 3.4 +/- 0.8 and 3.3 +/- 0.4 days in LP, I und II, respectively. Long-term results: After a mean of 24 months (19-42) the loss of body weight was 8.4 kg after 3, 13.9 kg after 6, 22.1 kg after 12 and 27.8 kg after 18 months in the LP. In group I after a mean of 14 months (12-19) 10.3 kg after 3, 18.7 kg after 6, 24.8 kg after 12 months. In group II after a mean of 10 months (6-16) the loss of body weight was 7.9 kg after 3 and 19.4 kg after 6 months. Conclusion: In our experience it appears that the SAGE is easy to handle and less prone to complications such as dysphagia and slipping, probably due to good fixation of the band due to its width. A prospective randomized trial is warranted.