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Banding, Bypass, and Sleeve Gastrectomy continued...

The gastric sleeve procedure involves the surgical removal of a portion of the stomach to create a "sleeve" that connects to the small intestine.

Just a few years ago, gastric banding was widely seen as less risky, less costly, and less invasive than either of the other surgical options, and about half of weight loss procedures in the U.S. involved banding.

But that has changed as the long-term data comparing weight loss surgeries has come in, says Ronald H. Clements, MD, who directs the bariatric surgery program at Vanderbilt University Medical Center in Nashville.

Fewer Lap-Band Surgeries Performed

Clements says just five of the 360 weight loss surgeries performed at Vanderbilt last year were Lap-Band procedures.

“We have essentially stopped doing this operation,” he says. “The sleeve and the bypass are just better for helping people lose weight and keep it off. That’s what we are seeing in our patients and that’s what the data are telling us.”

A 2011 study from Belgium found that the bands eroded in 1 in 3 patients, while 60% required additional surgeries.

And a study published last year that compared banding to bypass surgery found that bypass patients lost more weight and kept it off over six years and had fewer complications.

Four years ago, as many as 40% of weight loss surgeries performed at Lenox Hill Hospital in New York involved gastric banding, says Mitchell Roslin, MD, who is chief of obesity surgery.

Today, the figure is closer to 3%.

“Last year we took out 80 bands and converted them to other procedures,” he says. “Patients do well in the short term, but they tend to have problems later on.”

Banding Good Option for Some

American Society for Metabolic & Bariatric Surgery President Jaime Ponce, MD, confirms that fewer Lap-Band surgeries are being performed in the U.S.

Allergan’s sales related to its Lap-Band system reportedly fell from close to $300 million in 2011 to about half that figure last year, and last fall the company announced that it was looking to sell its weight loss surgery division.

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