Long-term data indicate a progressive loss in efficacy of adjustable silicone gastric banding for the surgical treatment of morbid obesity

Background. Many short-term follow-up reports on the efficacy of the adjustable, silicone gastric band (ASGB) and its modification for laparoscopic insertion (Lap-band)for the surgical treatment of morbid obesity have been reported in the surgical literature. However; long-term studies are larking. Methods. Between March 17, 1992, and January 7, 1997, 45 females and 17 male conservatively entered this prospective study. Forty ASGB and 22 Lap-Band were implanted. Mean age was 34 years (range 19-51); mean height was 171 cm (range 152-190); mean weight was 145 kg (range 100-214). Weight loss and adverse events associated with the device were observed over time, Results. There was no operative mortality. Thirty intra-abdominal reoperations were necessary to correct complications related to the implanted ASGB and the Lap-Band. In the ASGB cohort, the body mass index (BMI) decreased from 50 to 36 over a 3-year period and then increased to 44 at 8, years after operation. In the Lap-Band cohort the BMI decreased from 47 to 40 at 1 year and then increased to 43 at 6 years after operation. Twenty-seven implantable devices (18 ASGB, 9 Lap-Band) have been removed to date. Conclusion. The results of this study do not support the use of ASGB device for the surgical treatment of morbid obesity. The Lap-Band is less effective than ASGB.