Clinical outcomes of the REALIZE adjustable gastric band-C at one year in a U.S. population

• Published in: Surgery for obesity and related diseases Vol. 8; no. 3; pp. 288 - 295
• 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, Rodriguez, Claudio E., M.D, Gutierrez, Mario, M.S.H.S
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2012
• Subjects: Adolescent; Adult; Aged; Bariatric surgery; Body Mass Index; Female; Gastric band; Gastroenterology and Hepatology; Gastroplasty - instrumentation; Humans; Laparoscopic adjustable gastric band; Longitudinal Studies; Male; Middle Aged; Morbid obesity; Obesity, Morbid - surgery; Perioperative Care - methods; Postoperative Complications - etiology; REALIZE; Surgery; Swedish Adjustable Gastric Band; Treatment Outcome; United States; Weight Loss; Young Adult; United States; Body mass index; REALIZE; Laparoscopic adjustable gastric band; Gastric band; Bariatric surgery; Weight loss; Morbid obesity; Swedish Adjustable Gastric Band
• ISSN: 1550-7289; 1878-7533
• DOI: 10.1016/j.soard.2011.05.004

Abstract Background In 2008, the REALIZE Band (RB) adopted a precurved design (RB-C). The present study is the first multi-institutional report of RB-C outcomes. Our objective was to analyze the 1-year weight loss and safety data from adult RB-C patients treated at multiple U.S. centers (7 typical U.S. bariatric practices, including academic, nonacademic, public, and private practice). Methods Patients implanted with the RB-C (preoperative body mass index ≥40 kg/m2 or >35 kg/m2 with co-morbidity) were recruited. The exclusion criteria included the RB-C label contraindications for use. The outcomes parameters were the percentage of excess weight loss (%EWL), change in body mass index, number and volume of band adjustments, and incidence of complications. Results Of the 239 patients enrolled in the 2-year study, 158 had 1-year data available for analysis in November 2010. The mean %EWL was 39.2% ± 20.5% (range −7.7 to −116.8, P < .0001). The body mass index decreased from 44.4 ± 5.5 kg/m2 to 36.4 ± 5.8 kg/m2 ( P < .0001). The variability in the %EWL was significant among the study centers ( P < .0001). The average band fill volume at 1 year was 8.0 ± 2.0 mL (range .0–11.1). The total fill volume was >11 mL in 1 patient. No band erosions/migrations, explants, or deaths occurred. Conclusion RB-C appears to be as safe and effective as the first-generation RB. The near 40% EWL at 1 year was consistent with other high-quality publications of the RB. Good weight loss results are achievable, despite the varying postoperative management practices. The low morbidity and the absence of mortality at 12 months reflect positively on the RB-C characteristics. Our findings suggest that the learning curve, related to the postoperative management of the RB-C, might vary by practice and that a greater frequency and smaller band fills might result in better weight loss at 12 months.