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Home E-Weekly August 22, 2017

Surgeons Remove More Gastric Bands Than They Implant

Published: August 21, 2017

BAND AID The number of laparoscopic adjustable gastric band surgeries has dwindled in recent years, while other forms of bariatric surgery have grown in popularity.

Bariatric surgeons are now taking out or adjusting more of a once popular surgical weight-loss device than they're putting in. Researchers suggest the reversal of fortune may be due to the emergence of other surgical weight-loss alternatives that promise more dramatic results.

Laparoscopic adjustable gastric banding received FDA approval as a treatment for morbid obesity in 2001. It seems to have since fallen out of favor, say the authors of a new study published in the Journal of the American College of Surgeons. The annual number of implantation procedures began decreasing steadily after 2010, and surgeons have been performing more device explantations than implantations since 2013.

The researchers studied 28,202 patients who underwent laparoscopic adjustable gastric band implantation at academic medical centers from 2007 through 2015. In the same time period, 12,157 patients underwent explantation.

Laparoscopic adjustable gastric banding is one of the least invasive operations available for treating obesity. It requires just a few small cuts to the abdomen to place the inflatable belt around a portion of the stomach, which, in turn, reduces the amount of food the stomach can hold. Explantation or revision is a different story, as the procedure to remove or adjust the gastric band can lead to a longer hospital stay, a greater number of serious complications and a higher likelihood of being admitted to the ICU, the study finds.

The study does not explain why the bands were removed, so it's tough to determine if the removals stemmed from complications or patient desires for a different surgical weight-loss option. Some have suggested the decline may be to due to the rise to prominence of other surgical weight-loss procedures, such as the laparoscopic sleeve gastrectomy.

The sleeve gastrectomy accounted for more than half of all surgical weight-loss procedures performed in the United States in 2015, according to the American Society for Metabolic and Bariatric Surgery, up from just 17.8% in 2011. Comparatively, laparoscopic adjustable gastric banding accounted for just 5.7% of bariatric procedures in 2015, down from 35.4% in 2011.

Other forms of bariatric surgery have been in the headlines of late. Earlier this month, the U.S. Food & Drug Administration issued a second safety warning to healthcare providers in the aftermath of 5 patient deaths that occurred soon after the patients were implanted with liquid-filled intragastric balloons.

Bill Donahue

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