Does the Size and Type of Lap-Band Impact Long Term Outcomes?
A. Ardestani, MD, Abolmaali Kamran, MD, Ali Tavakkolizadeh, MD
Brigham and Women’s Hospital, Boston, MA
PURPOSE OF STUDY
Laparoscopic adjustable banding for weight loss is increasing in popularity. The band design has undergone significant recent changes to improve outcomes and reduce complications. To evaluate the impact of these changes, we studied the impact of different bands on the long term outcomes of the procedure.
We reviewed our bariatric database to identify patients who had undergone gastric banding, with a minimum of 24-months follow-up. Patients’ medical records were utilized to retrieve not tracked data. Due to the 24-months minimum follow-up requirement, only 2 band types were included: Lap-Band standard (LB-S) and Lap-Band VG (LB-VG).
SUMMARY OF RESULTS
A total of 433 patients met our inclusion criteria. 320(74%) received LB-S and 113(26%) LB-VG. Group data and outcomes are summarized in Table 1. Of the patients with a LB-S, 76(23.8%) required a surgical intervention due to a band related complication, compared to 13(11.6%) in the LB-VG group. Multivariate analysis confirmed band type and follow-up period as independent risk factors for surgical intervention (p= 0.02 and 0.01, respectively). The LB-S resulted in greater Excess Weight Loss (EWL) at 1 and 2-years post-op, however this difference was not seen after 3 years (Table 1).
The smaller size of the LB-S introduces more restriction that could result in more rapid weight loss; however the same mechanism might increase the risk of complications, which leads to a significantly higher re-operation rate. Since the weight loss between the bands is similar at 3-years, we encourage the use of larger bands for gastric banding surgery.
TABLES AND CHARTS
Patient demographics and outcomes