Clinical outcomes of the Realize Adjustable Gastric Band-C at 2 years in a United States population

• Published in: Surgery for obesity and related diseases Vol. 9; no. 6; pp. 885 - 893
• Main Authors: Cunneen, Scott A., M.D, Brathwaite, Collin E.M., M.D, Joyce, Christopher, M.D, Gersin, Keith, M.D, Kim, Keith, M.D, Schram, Jon L., M.D, Wilson, Erik B., M.D, Schwiers, Michael, M.S, Gutierrez, Mario, M.S.H.S
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2013
• Subjects: Adult; Bariatric surgery; Body Mass Index; Female; Follow-Up Studies; Gastric band; Gastroenterology and Hepatology; Gastroplasty - adverse effects; Gastroplasty - instrumentation; Humans; LAGB; laparoscopic adjustable gastric band; Longitudinal Studies; Male; Middle Aged; Morbid obesity; Obesity, Morbid - diagnosis; Obesity, Morbid - surgery; Postoperative Complications - physiopathology; Postoperative Complications - surgery; Prosthesis Design; Prosthesis Failure; Realize; Realize Adjustable Gastric Band; Reoperation - methods; Retrospective Studies; Risk Assessment; Surgery; Time Factors; Treatment Outcome; United States; Weight Loss; United States; LAGB; Realize; Realize Adjustable Gastric Band; Gastric band; Bariatric surgery; Morbid obesity; laparoscopic adjustable gastric band
• ISSN: 1550-7289; 1878-7533
• DOI: 10.1016/j.soard.2013.02.009

Abstract Background In 2008, the Realize Band (RB) adopted a precurved design (RB-C). We present 2-year outcomes data from the first multiinstitutional study of RB-C. The objective of this study was to analyze weight loss and safety data from bariatric practices in the United States, including academic, nonacademic, public, and private. Methods The study included adult RB-C patients with a preoperative body mass index (BMI)≥40 kg/m2 or>35 kg/m2 with co-morbidity. Exclusions included RB-C’s label contraindications for use. Outcomes parameters were percent excess weight loss (%EWL), BMI change, number and volume of band adjustments, and adverse events. Results A total of 231 patients met inclusion/exclusion criteria. Of these, 161 had 24-month data available. Mean %EWL was 44.4%±26.9% ( P <.0001). BMI decreased from 44.1±5.7 kg/m2 to 35.3±6.9 kg/m2 ( P <.0001). Percent EWL varied by preoperative BMI (P = .0002 ), bariatric practice ( P <.0001), aftercare frequency ( P = .0004), and band fill frequency ( P = .0271), but %EWL was not influenced by gender, race, or age ( P >.20 each). Adverse events were dysphagia (21.2%), gastroesophageal reflux (21.6%), and vomiting (30.7%). Incidence of pouch dilation, esophageal dilation, and slippage was≤1%. Revisions (2.2%) were for unbuckled band, tube kinking, slippage, and suspected band leak (1 each). No erosions, explants, or mortality were reported. Conclusion RB-C appears to be as well tolerated and effective as the first generation RB for weight loss. The near 45% EWL at 2 years is consistent with other high-quality publications on the RB. Preoperative BMI and frequency of postoperative care, including frequency of band fills, influence %EWL. Significant weight loss is achievable with RB-C despite variable postoperative management practices. The low morbidity and the absence of mortality at 24 months reflect positively on the RB-C characteristics.