A 5-Year History of Laparoscopic Gastric Band Removals: an Analysis of Complications and Associated Comorbidities

• Published in: Obesity surgery Vol. 29; no. 4; pp. 1202 - 1206
• Main Authors: Jaber, Jamil, Glenn, Jordan, Podkameni, David, Soto, Flavia
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.04.2019; Springer Nature B.V
• Subjects: Adolescent; Adult; Bariatric Surgery - adverse effects; Bariatric Surgery - instrumentation; Bariatric Surgery - rehabilitation; Bariatric Surgery - statistics & numerical data; Comorbidity; Deglutition Disorders - epidemiology; Deglutition Disorders - etiology; Deglutition Disorders - surgery; Device Removal - adverse effects; Device Removal - rehabilitation; Device Removal - statistics & numerical data; Dysphagia; Female; Follow-Up Studies; Gastroplasty - adverse effects; Gastroplasty - instrumentation; Gastroplasty - rehabilitation; Gastroplasty - statistics & numerical data; Humans; Laparoscopy; Laparoscopy - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity, Morbid - epidemiology; Obesity, Morbid - surgery; Original Contribution; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Reoperation - adverse effects; Reoperation - methods; Reoperation - rehabilitation; Reoperation - statistics & numerical data; Retrospective Studies; Risk Factors; Surgery; Time Factors; Treatment Outcome; Young Adult; Gastric band; Removals
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-018-03677-4

Objective This study was undertaken to examine the factors contributing to laparoscopic adjustable gastric band (LAGB) removals among adults > 18 years of age. We hypothesized that female patients with multiple comorbidities would have increased removals. Design This retrospective exploratory study uses internal records and standard statistical methods of analysis. Results Eighty-five bands were removed (11.8% males, 88.2% females). The average BMI was 40.7 ( n  = 83). 2.4% of patients had removals between 0 and 12 months, 18.8% between 39 and 51 months, and 35.3% between 39 and 64 months. 8.2% of treatment times were unknown. The average treatment time was 67.9 months. 48.2% of patients had ≥ 2 comorbidities, GERD (44.2%) being the most frequent. 49.4% of patients reported dysphagia as the reason for band removal. 22.4% of removals were associated with band failures, none with port complications. The reason for band removal was unknown in 21.2% of patients. 67.1%, 32.9%, and 23.5% attended 30-, 60-, and 90-day follow-up appointments, respectively. Weight post-band removal surgery at 30, 60, and 90 days was noted to be − 0.4%., 0.9%, and 0.4%, respectively. Conclusion This study supports current literature suggesting LAGB may not be an effective long-term surgical intervention for obesity. Patients with > 2 comorbidities had increased rates of removal. Dysphagia was noted to be the primary reason cited for LAGB removal. Postoperative follow-up was found to be a significant challenge for LAGB removal patients. Further study is warranted to explore if these poor follow-up rates should be considered when risk stratifying LAGB patients for revisional surgery.