After any medical device receives approval from the Food and Drug Administration for use in the clinic, it is important that research clinicians continue conducting studies with the medical device in order to assure long-term safety and efficacy, despite success in the short-term. In fact, this is an FDA requirement. Laparoscopic adjustable gastric banding (LAGB) has been gaining in popularity as a bariatric surgery option for obese patients and is safe and effective in the short-term. To identify how morbidly obese patients respond to LAGB in the long-term, a group of researchers from Iran and the United Kingdom conducted a 13-year follow-up study, “Laparoscopic Adjustable Gastric Banding: Efficacy and Consequences Over a 13-Year Period,” which was published in The American Journal of Surgery.
“Globally, one of the most common bariatric surgical procedures is laparoscopic adjustable gastric banding (LAGB),” wrote Karamollah Toolabi, MD, lead author on the paper. “This method is relatively safe and effective on treatment of obesity and comorbidities over the short-term and mid-term.”
Accordingly, the research team conducted a 13-year study to investigate how obese patients respond to LAGB and if they experience the major complications of band erosion, slippage, port infection, pouch and esophageal dilation, and weight loss failure. A total of 80 patients who were considered morbidly obese received LAGB between the years of 2001 and 2006, then continued to follow-up with their clinicians to report any postoperative consequences and complications.
At the end of the study period, 85% of the patients experienced at least one complication, with the most common complication being band erosion in 30% of the patients. Some patients also experienced band infection or band slippage, and all three of these complications were treated by band removal. However, an additional 16 patients — 20% of the study — had their bands removed due to dissatisfaction from weight regain or diet intolerance, and another 20 bands were removed for the patients to undergo other bariatric surgeries.
In order for gastric bands to be effective, it is paramount that patients adhere to the dietary indications for the device. Binge eating, overeating, and other unhealthy eating habits that led to patients becoming obese or morbidly obese must be halted once the band is installed, or else adverse side-effects like nausea and vomiting, as well as a lack of weight loss are all likely to occur.
In spite of this, Dr. Toolabi remarked that overall”LAGB is a successful method with low complications in short-term” even though data from the study showed that “over long-term, it results in various complications” in morbidly obese patients. These findings were consistent with previous studies and suggest that it is important for clinicians and patients to discuss all options to decide if LAGB is truly a good option for significant weight reduction, and to underscore the importance of making lifestyle changes with the gastric band.