The document discusses laparoscopic adjustable gastric banding (LAGB) as a treatment for obesity. It provides evidence that LAGB significantly reduces co-morbidities and mortality risk over 5 years compared to other weight loss surgeries. LAGB has advantages such as lower complication and mortality rates compared to gastric bypass, but requires lifelong adjustments and follow-ups to the implanted band. Patient selection is important for success of LAGB.
9. Comparing Weight Loss Results Reference: 1. O’Brien P, McPhail T, Chaston T, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg . 2006:16;1032-40. Laparoscopic adjustable gastric banding (LAGB) provides effective weight loss after 3 years, comparable to that seen with standard gastric bypass 1 *LAGB using the LAP-BAND ® System and another adjustable gastric band. Comparison is based on pooled data from 43 peer-reviewed reports involving at least 100 patients at entry and providing at least 3 years postoperative data.
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13. Comparison of Average Recovery Time 1 Reference: 1. Fisher BL. Comparison of recovery time after open and laparoscopic gastric bypass and laparoscopic adjustable banding. Obesity Surgery. 2004;14;67-72. The LAP-BAND ® System n=21 Open Bypass n=20 Lap. Bypass n=19 Length of Hospital Stay (Days) 1.3 3.5 2.5 Days to Normal Activity 7.2 17.6 18.2 Recovery (Days) 15.8 29.1 21.7
With the LAP-BAND ® System, weight loss is slow and gentle—not as rapid from the start as with Gastric Bypass. Regular follow-up visits for nutrition and exercise education as well as for adjustments are necessary, however, for optimum results.
Although initial weight loss with Gastric Bypass is typically very rapid, at 5 years many LAP-BAND ® System and Gastric Bypass patients achieve comparable weight loss results. 55% of excess weight for the LAP-BAND ® System versus 59% with Gastric Bypass. * O’Brien P, McPhail T, Chaston T, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006: 16; 1032-1040.
The LAP-BAND® System procedure is major surgery. As with any surgery there are possible risks and complications with the LAP-BAND® System including but not limited to infection, nausea, vomiting, band slippage and obstruction. all can be corrected with additional laparoscopic surgery. There is also a risk associated with the patients ability to tolerate an foreign object implanted in the body. Not all risks and complications are included in this presentation. For detailed risk information please visit www.lapband.com.
Prospective study on lap bariatric procedures with complications categorized using Clavien’s methodology (Clavien P. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery 1992; 111:518-526) for severity scores. Grade 3 and 4 are considered “major.” Grade Definition LAP-BAND® System RYGB BPD 1 Events carrying minor risk IV for hydration, hospitalized for nausea IV for hydration, hospitalized for nausea IV for hydration, hospitalized for nausea 2 Events requiring drug therapy, transfusions, hospital stay > 2x median stay Prolonged LOS for post-op edema Leak managed with TPN, PE Pancreatis, delayed gastric emptying 2b Events requiring endoscopy or reop (not requiring organ resection) Port or band revision Reop for bleeding, exploratory lap Reop for bleeding, exploratory lap 3 Events with lasting disability or requiring organ resection Sigmoid esophagus Revision of anastomosis, bowel resection Revision of anastomosis, bowel resection 4 Death Death Death Death