Skip to main content

Advertisement

Log in

Perioperative Outcomes of Laparoscopic Adjustable Gastric Banding in Mildly Obese (BMI < 35 kg/m2) Compared to Severely Obese

  • Clinical Report
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Laparoscopic adjustable gastric banding (LAGB) has become a standard restrictive procedure in the USA for the treatment of severe obesity (body mass index, BMI > 35 kg/m2). Mildly obese individuals (BMI < 35 kg/m2) are also at increased risk from obesity-related conditions. Recently, an FDA panel supported its use in this subgroup. We compared the perioperative outcomes of LAGB in mildly and severely obese. Thirty consecutive patients (mildly obese n = 10; severely obese n = 20) that underwent preoperative medical weight loss followed by LAGB procedures were prospectively evaluated. Outcome variables included: operative room (OR) time, intraoperative estimated blood loss (EBL), length of hospital (LOS), and intensive care unit (ICU) stay, reoperations, readmissions, 30-day morbidity and mortality. Demographic data was comparable between groups. BMI was significantly higher in the severely obese compared to mildly obese (44.0 ± 5 vs. 33.6 ± 1 kg/m2). OR time, EBL, LOS, and ICU admissions were similar between BMI groups. There were no reoperations or 30-day mortality in either group. Minor morbidity was only observed in the severely obese group. BMI correlated with OR time and EBL. In mildly obese, LAGB is as safe as in the severely obese with no perioperative morbidity. The perioperative outcomes and hospital resource utilization are comparable between BMI groups. Lower BMI is associated with lower operative times and blood loss.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Nguyen NT, Hinojosa M, Fayad C, et al. Use and outcomes of laparoscopic versus open gastric bypass at academic medical centers. J Am Coll Surg. 2007;205(2):248–55.

    Article  PubMed  Google Scholar 

  2. Hinojosa MW, Varela JE, Parikh D, et al. National trends in use and outcome of laparoscopic adjustable gastric banding. Surg Obes Relat Dis. 2009;5(2):150–5.

    Article  PubMed  Google Scholar 

  3. Gastrointestinal Surgery for Severe Obesity (2009) NIH Consensus Statement Online. 1991; Mar 25–27; 9(1):1–20

  4. Varela JE, Hinojosa MW, Nguyen NT. Bariatric surgery outcomes in severely obese with the metabolic syndrome at US academic centers. Obes Surg. 2008;18(10):1273–7.

    Article  PubMed  Google Scholar 

  5. Ren CJ, Horgan S, Ponce J. US experience with the LAP-BAND system. Am J Surg. 2002;184(6B):46S–50.

    Article  PubMed  Google Scholar 

  6. Ponce J, Paynter S, Fromm R. Laparoscopic adjustable gastric banding: 1,014 consecutive cases. J Am Coll Surg. 2005;201(4):529–35.

    Article  PubMed  Google Scholar 

  7. Ponce J, Haynes B, Paynter S, et al. Effect of Lap-Band-induced weight loss on type 2 diabetes mellitus and hypertension. Obes Surg. 2004;4(10):1335–42.

    Article  Google Scholar 

  8. Berrington de Gonzalez A, Hartge P, Cerhan JR, et al. Body mass index and mortality among 1.46 million white adults. N Engl J Med. 2010;363(23):2211–9.

    Article  CAS  PubMed  Google Scholar 

  9. Dixon JB, O’Brien PE, Playfair J, et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA. 2008;299(3):316–23.

    Article  CAS  PubMed  Google Scholar 

  10. O'Brien PE, Dixon JB, Laurie C, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomized trial. Ann Intern Med. 2006;144(9):625–33.

    PubMed  Google Scholar 

  11. Parikh M, Duncombe J, Fielding GA. Laparoscopic adjustable gastric banding for patients with body mass index of < or = 35 kg/m2. Surg Obes Relat Dis. 2006;2(5):518–22.

    Article  CAS  PubMed  Google Scholar 

  12. Lautz DB, Jackson TD, Clancy KA, et al. Bariatric operations in Veterans Affairs and selected university medical centers: results of the patient safety in surgery study. J Am Coll Surg. 2007;204(6):1261–72.

    Article  PubMed  Google Scholar 

  13. Varela JE, Wilson SE, Nguyen NT. Outcomes of bariatric surgery in the elderly. Am Surg. 2006;72(10):865–9.

    PubMed  Google Scholar 

  14. Sugerman H, Windsor A, Bessos M. Intra-abdominal pressure, sagittal abdominal diameter and obesity comorbidity. J Intern Med. 1997;241(1):71–9.

    Article  CAS  PubMed  Google Scholar 

  15. Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.

    Article  PubMed  Google Scholar 

  16. Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.

    Article  PubMed  Google Scholar 

  17. Wadden TA, Tsai AG. Bariatric surgery: crossing a body mass index threshold. Ann Intern Med. 2006;144(9):689–91.

    PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported in part by a New Investigator Award by the Veterans Affairs Healthcare System.

Conflict of Interest

We have nothing to disclose that is relevant to this work.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. Esteban Varela.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Varela, J.E., Frey, W. Perioperative Outcomes of Laparoscopic Adjustable Gastric Banding in Mildly Obese (BMI < 35 kg/m2) Compared to Severely Obese. OBES SURG 21, 421–425 (2011). https://doi.org/10.1007/s11695-011-0365-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-011-0365-6

Keywords

Navigation