Laparoscopic adjustable gastric band survival in a high-volume bariatric unit

Br J Surg. 2013 Nov;100(12):1614-8. doi: 10.1002/bjs.9284.


Background: Although laparoscopic adjustable gastric bands (LAGBs) have been shown to be efficacious, their long-term usefulness has been questioned. This study examined the fate of LAGBs in a unit with over a decade of experience in their use. Patient factors related to the need for, and timing of, band removal were investigated.

Methods: A prospectively maintained database was used to identify all patients with a LAGB. Patient demographics, need for band removal and band survival were examined. Logistic regression modelling was done and Kaplan-Meier curves were calculated for band survival.

Results: Between 2000 and 2012, 674 bands were placed in 665 patients. Of these, 143 (21.2 per cent) were removed. There was no difference in rates of removal by sex (P = 0.910). The highest rates of removal were in patients aged less than 40 years (26.7 per cent), and those with a BMI greater than 60 kg/m2 (28.6 per cent). Earlier band removal was seen in younger patients (P = 0.002). Rates of removal increased linearly by earlier year of placement. Of bands placed 4 or more years previously, 35.0 per cent required removal. Eighty-three patients (58.0 per cent) who had a LAGB removed went on to have a further bariatric procedure (band to bypass, 66; band to sleeve, 17).

Conclusion: Even in experienced hands LAGB does not appear to be a definitive solution. In a large number of patients there appears to be a finite 'band life', with the majority of patients requiring conversion to a further bariatric procedure.

MeSH terms

  • Adult
  • Body Mass Index
  • Device Removal / statistics & numerical data
  • Female
  • Gastric Bypass / methods
  • Gastric Bypass / statistics & numerical data*
  • Gastroplasty / methods
  • Gastroplasty / statistics & numerical data*
  • Humans
  • Kaplan-Meier Estimate
  • Laparoscopy / statistics & numerical data*
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Prospective Studies
  • Retrospective Studies