Favorable early results of gastric banding for morbid obesity: the American experience

Background: In 2001 a new device for surgical weight loss was approved by the Food and Drug Administration (Lap-Band, Inamed Health). We describe initial results of laparoscopic gastric banding for morbid obesity in two American academic centers. Methods: Prospective data was collected on consecutive morbidly obese patients undergoing laparoscopic adjustable gastric banding, and evaluated retrospectively. Results: Four hundred forty-five consecutive patients underwent Lap-Band from May 2001 through December 2002. The 103 men and 341 women had an average age of 42.1 years (range 17–72 years) and an average body mass index (BMI) of 49.6 kg/m² (range 35.2–92.2 kg/m²). One operation required conversion to laparotomy due to bleeding; the rest were completed laparoscopically. Mean length of stay was 1.1 days (range 1–10 days). There was one death. Additional complications included band slippage in 14 patients (3.1%), gastric obstruction without slip in 12 (2.7%), port migration in 2 (0.4%), tubing disconnections in 3 (0.7%), and port infection in 5 (1.1%). Two bands (0.4%) were removed due to intraabdominal abscess 2 months after placement. There was one band erosion (0.2%) and no clinically significant esophageal dilation. Ninety-nine patients have 1-year follow-up and have lost an average of 44.3% excess body weight. Conclusion: Laparoscopic gastric banding has much to offer the morbidly obese. We present data showing weight loss rivaling gastric bypass and acceptably low complications. These results parallel success with this device outside America.