The Pattern of Adjustments after Laparoscopic Adjustable Gastric Band.

BACKGROUND

The success of laparoscopic adjustable gastric band (LAGB) is dependent on gradual adjustments over time. The aim of this study is to describe that pattern of LAGB adjustments that are required after surgery.

METHODS

A non-randomized observational study of consecutive LAGB from a single practise. Patients were sourced from a prospective database. Details of each LAGB adjustment were recorded along with weight loss and complications.

RESULTS

There were 125 consecutive LAGB between March 2009 and September 2011 (mean age 46.6 ± 11.9 years; 113 female, BMI 42.1 ± 5.9 kg/m(2)). The mean %EBWL was 41.4 ± 19.1 % at 2 years. There was a total of 746 band adjustments with mean 7.1 ± 4.4 per patient. Approximately, a third of patients (34 %) reached optimal volume within 6 months but 49 patients (39 %) still required adjustments beyond a year. Weight loss was maximal prior to the first adjustment (41 % of mean total weight loss). The rate of weight loss decreased down to 1-3 %EBWL between later fills despite repeated increases in band volume. Urgent deflations were required in 63 patients with 24 of these patients having multiple overfills. There were two patients who had gastric prolapse but no other LAGB-related complications occurred in the first 2 years after surgery.

CONCLUSIONS

LAGB requires a considerable postoperative commitment that may take several months. Overfills are common and may be the result of a false perception that tightening the band will hasten weight loss.