Chapter 34. Bariatrics: Effectiveness of Gastric Banding

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What we are researching: What is the effectiveness of gastric banding?

What's new: What are the consequences of gastric band erosion?

What we will learn: How can a resume help us understand the effectiveness of gastric banding?

1. Complications or failure to lose weight after LAGB* are probably the most common reason for revision surgery** accounting for up to 73% of all patients undergoing revision (Ma IT, Madura JA 2nd. 2015) [1 ].

* LAGB - laparoscopic adjustable gastric banding (fr. 32.1, footnote)

** Revision surgery is done to correct complications after the first surgery.

2. Types of operations. Let's look at the various bariatric surgeries that are most common in the United States as of 2020. These include a duodenal switch (DS), laparoscopic gastric bypass (LRYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric banding (LAGB)*. We will devote this chapter to the procedure of bariatric surgery, laparoscopic adjustable gastric banding (hereinafter referred to as gastric banding) **. Let us briefly explain the characteristics of the changes in the procedure of this operation. We are exploring the effectiveness and side effects of gastric banding. After considering all the above operations, we will know their results 1 – 2 years after the operation, when maximum weight loss is achieved (Chapter 35. "Bariatrics: Summary of Effectiveness") [1, 2, 3, 4, 5]. Let's draw conclusions that will help you make a wise choice. So, what is gastric band surgery?

*All descriptions of types of surgical procedures and estimates of the number of operations are taken from the official ASMBS/Resources/Metabolic and Bariatric Surgery website: https://asmbs.org/resources/metabolic-and-bariatric-surgery

** Bariatric operations on the duodenal switch (DS), laparoscopic gastric bypass (LRYGB), and sleeve gastrectomy (SG) are dedicated to chapters 31, 32, and 33 of this book, respectively.

3. Gastric banding (LAGB). As of 2019, the estimate for the number of transactions was 0.9%. The prevalence of gastric band surgery continues to decline as of 2020 [4]. This operation has no anatomical changes, is reversible, and is less invasive (penetration into the body) in comparison with previous operations [1, 6]. Gastric banding involves an adjustable silicone band that is filled with saline. This tape is wrapped around the upper part of the stomach, forming a small pouch that limits food intake (fr. 31.4). How effective is this surgery in reducing body weight?

4. Efficiency. The maximum reduction in body weight was 20±10% (%TWL), i.e. the smallest in bariatric surgery [5]. However, the frequency of reductions in signs of concomitant diseases occurs in a significantly smaller number of patients (≈ 2-3 times) than with gastric bypass surgery [2, 7].

5. Side effects. Despite a relatively low complication rate (13%), gastric banding has the highest reoperation rate in the long term [1, 2].

 Despite a relatively low complication rate (13%), gastric banding has the highest reoperation rate in the long term [1, 2]

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