Surgical management of obesity using a soft adjustable gastric band

Background: Laparoscopically inserted adjustable gastric bands are an effective means of weight reduction for obese patients. Methods: The Swedish Adjustable Gastric Band was evaluated prospectively in a consecutive series of 273 patients from August 1996 to March 2003. Results: The first 58 patients had their band sited by the 'peri-gastric' technique, with the subsequent 215 using the 'pars flaccida' technique, which provides better posterior fixation of the band. Results from these two groups were considered separately. Prolapse of the stomach through the band was the major complication occurring in 13 of the 58 peri-gastric patients (22.4%). Median preoperative body mass index (BMI) was 42.1, falling below 30 by 2 years. In the pars flaccida group there were no instances of prolapse, but the major complication was three cases of band erosion (1.4%). Median preoperative BMI was 42.9 for this group, falling to 32 by 3 years. There was one death in the series due to myocardial infarction. Conclusions: Results compare favourably with other published adjustable gastric band series. Weight loss with the SAGB appears durable overall with an acceptable complication rate once an appropriate technique is employed. Consistent life-long follow up is necessary to achieve the best result.