High failure rate of the laparoscopic-Adjustable gastric band as a primary bariatric procedure

Tammy Kindel*, Emily Martin, Eric Hungness, Alex Nagle

*Corresponding author for this work

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background Determinants of success of a bariatric procedure are many but paramount is the ability to durably produce significant and reliable weight loss. We sought to determine the primary success of the laparoscopic adjustable gastric band (LAGB) by defining failure as clinical weight loss failure with an intact band (excess weight loss [EWL]<20%) or band removal (terminal removal or conversion to a secondary bariatric procedure).

Methods A retrospective chart review was performed on patients who underwent an LAGB as a primary bariatric procedure between January 2003 and December 2007. Data collected included body mass index (BMI), weight, postoperative follow-up length, EWL, and adjustment number, as well as complications of the LAGB.

Results Sixteen of 120 patients had the band removed. Nine were terminally removed for unmanageable symptoms, and 7 were converted to an alternative bariatric procedure. The average follow-up for the 104 patients with an intact band was 4.8 years. The average EWL for successful intact bands was 44.9±19.4%; however, an additional 35.6% of patients had an EWL<20%. Patients with an EWL<20% had a significantly higher preoperative BMI and fewer band adjustments. In total, 44% of patients had band failure because of clinical weight loss failure (31%) or eventual band removal (13%).

Conclusion This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients because of either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients because of its high failure rate.

Original languageEnglish (US)
Pages (from-to)1070-1075
Number of pages6
JournalSurgery for Obesity and Related Diseases
Volume10
Issue number6
DOIs
StatePublished - Nov 1 2014

Fingerprint

Bariatrics
Weight Loss
Stomach
Body Mass Index

Keywords

  • Band failure
  • Laparoscopic adjustable gastric band
  • Weight loss failure

ASJC Scopus subject areas

  • Surgery

Cite this

@article{5d8a890f15cf466fbb85f7b74d634753,
title = "High failure rate of the laparoscopic-Adjustable gastric band as a primary bariatric procedure",
abstract = "Background Determinants of success of a bariatric procedure are many but paramount is the ability to durably produce significant and reliable weight loss. We sought to determine the primary success of the laparoscopic adjustable gastric band (LAGB) by defining failure as clinical weight loss failure with an intact band (excess weight loss [EWL]<20{\%}) or band removal (terminal removal or conversion to a secondary bariatric procedure).Methods A retrospective chart review was performed on patients who underwent an LAGB as a primary bariatric procedure between January 2003 and December 2007. Data collected included body mass index (BMI), weight, postoperative follow-up length, EWL, and adjustment number, as well as complications of the LAGB.Results Sixteen of 120 patients had the band removed. Nine were terminally removed for unmanageable symptoms, and 7 were converted to an alternative bariatric procedure. The average follow-up for the 104 patients with an intact band was 4.8 years. The average EWL for successful intact bands was 44.9±19.4{\%}; however, an additional 35.6{\%} of patients had an EWL<20{\%}. Patients with an EWL<20{\%} had a significantly higher preoperative BMI and fewer band adjustments. In total, 44{\%} of patients had band failure because of clinical weight loss failure (31{\%}) or eventual band removal (13{\%}).Conclusion This study finds that the LAGB failed as a primary bariatric procedure for 44{\%} of patients because of either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients because of its high failure rate.",
keywords = "Band failure, Laparoscopic adjustable gastric band, Weight loss failure",
author = "Tammy Kindel and Emily Martin and Eric Hungness and Alex Nagle",
year = "2014",
month = "11",
day = "1",
doi = "10.1016/j.soard.2013.11.014",
language = "English (US)",
volume = "10",
pages = "1070--1075",
journal = "Surgery for Obesity and Related Diseases",
issn = "1550-7289",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - High failure rate of the laparoscopic-Adjustable gastric band as a primary bariatric procedure

AU - Kindel, Tammy

AU - Martin, Emily

AU - Hungness, Eric

AU - Nagle, Alex

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Background Determinants of success of a bariatric procedure are many but paramount is the ability to durably produce significant and reliable weight loss. We sought to determine the primary success of the laparoscopic adjustable gastric band (LAGB) by defining failure as clinical weight loss failure with an intact band (excess weight loss [EWL]<20%) or band removal (terminal removal or conversion to a secondary bariatric procedure).Methods A retrospective chart review was performed on patients who underwent an LAGB as a primary bariatric procedure between January 2003 and December 2007. Data collected included body mass index (BMI), weight, postoperative follow-up length, EWL, and adjustment number, as well as complications of the LAGB.Results Sixteen of 120 patients had the band removed. Nine were terminally removed for unmanageable symptoms, and 7 were converted to an alternative bariatric procedure. The average follow-up for the 104 patients with an intact band was 4.8 years. The average EWL for successful intact bands was 44.9±19.4%; however, an additional 35.6% of patients had an EWL<20%. Patients with an EWL<20% had a significantly higher preoperative BMI and fewer band adjustments. In total, 44% of patients had band failure because of clinical weight loss failure (31%) or eventual band removal (13%).Conclusion This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients because of either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients because of its high failure rate.

AB - Background Determinants of success of a bariatric procedure are many but paramount is the ability to durably produce significant and reliable weight loss. We sought to determine the primary success of the laparoscopic adjustable gastric band (LAGB) by defining failure as clinical weight loss failure with an intact band (excess weight loss [EWL]<20%) or band removal (terminal removal or conversion to a secondary bariatric procedure).Methods A retrospective chart review was performed on patients who underwent an LAGB as a primary bariatric procedure between January 2003 and December 2007. Data collected included body mass index (BMI), weight, postoperative follow-up length, EWL, and adjustment number, as well as complications of the LAGB.Results Sixteen of 120 patients had the band removed. Nine were terminally removed for unmanageable symptoms, and 7 were converted to an alternative bariatric procedure. The average follow-up for the 104 patients with an intact band was 4.8 years. The average EWL for successful intact bands was 44.9±19.4%; however, an additional 35.6% of patients had an EWL<20%. Patients with an EWL<20% had a significantly higher preoperative BMI and fewer band adjustments. In total, 44% of patients had band failure because of clinical weight loss failure (31%) or eventual band removal (13%).Conclusion This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients because of either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients because of its high failure rate.

KW - Band failure

KW - Laparoscopic adjustable gastric band

KW - Weight loss failure

UR - http://www.scopus.com/inward/record.url?scp=84924079454&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84924079454&partnerID=8YFLogxK

U2 - 10.1016/j.soard.2013.11.014

DO - 10.1016/j.soard.2013.11.014

M3 - Article

VL - 10

SP - 1070

EP - 1075

JO - Surgery for Obesity and Related Diseases

JF - Surgery for Obesity and Related Diseases

SN - 1550-7289

IS - 6

ER -