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Study: Poor Results From Lap-Band Surgery

Researchers Say Weight Loss From Lap-Band Is Relatively Low; Critics Say Study Has Flaws
WebMD Health News
Reviewed by Laura J. Martin, MD

March 21, 2011 -- Long-term results for Lap-Band weight loss surgery are relatively poor, according to a new study from Belgium.

But a spokesman for the company that manufactures Lap-Band says the study is flawed.

Nearly half of the 82 patients followed for 12 years or longer required removal of the bands and about 40% had major complications, the researchers found. The average weight loss was below what experts consider good results.  Even so, a majority of the patients in their small study said they were satisfied with the procedure.

Despite that degree of satisfaction, "I think people have exaggerated expectations from the band procedure," says researcher Jacques Himpens, MD, an attending surgeon at St. Pierre University Hospital in Brussels. His study findings, he tells WebMD, are ''a reality call."

But some, including the manufacturer of the Lap-Band -- used in a technique called laparoscopic adjustable gastric banding -- take exception to the study, criticizing the small sample size and the number of patients lost to follow-up.

The critics also point out that both the device itself and the expertise of surgeons placing it have improved greatly since the patients in the study had their bands placed, in the years 1994 through 1997.

But Himpens tells WebMD he's skeptical either would make much difference. "My impression is, even with the newer band, the results are not significantly better," he says.

He emphasizes he is not against the use of gastric band surgery, but that based on his study results, patients who opt for the procedure should know there's a good chance they will need a follow-up procedure and they may have less weight loss and more complications than those who choose other weight loss surgeries.

Weight Loss Surgery

In 2009, about 220,000 obese people had bariatric surgery, according to the American Society for Metabolic & Bariatric Surgery, choosing from the gastric banding technique, gastric bypass surgery, and other procedures. Gastric banding involves creating a small pouch by wrapping a silicone band around the upper part of the stomach, thus making a patient feel full after eating less.

The Belgian research, published in the Archives of Surgery, is thought to be the first study that follows gastric banding patients for more than 10 years.

Himpens and his colleagues set out to follow 151 patients who had the procedure from 1994 to 1997. They wanted to assess a number of outcomes, including death rate, complications both minor and major, amount of weight loss, number of corrective operations, effect on other problems such as high blood pressure and patient satisfaction.

The median age of the patients was 50 (half were older, half were younger). Many patients were lost to follow-up, with just 54.3% or 82 having full data available.

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