Past, present, and future: Critical analysis of use of gastric bands in obese patients

Abstract

Adjustable gastric banding (AGB) is quickly becoming the most popular bariatric operation performed in the United States and Canada. Patients are particularly fond of the simplicity of the tool, the relatively low morbidity of the surgery, the quick recovery, and overall results. The gastric band has evolved over its 35-year history into a very successful adjustable tool used to restrict food consumption and limit caloric intake. The percent of excessive weight loss after banding can range from 30%–60% and depends on the time out from surgery. Along with weight loss, there is good resolution of the co-morbid conditions that are associated with excess weight and improvements in quality of life demonstrated after banding. Nutrition and follow up are extremely important after banding to ensure good compliance and adequate weight loss. Failure to follow the postoperative diet, exercise regiment, or mechanical failure of the band can lead to failure to lose adequate weight. While there are particular early and late complications associated with this surgery, the safety profile of the AGB is very appealing when compared to other bariatric operations. As we continue to reduce the morbidity of the procedure, the simple adjustable band concept has a lot of potential to remain a primary technique of maintaining long term weight loss. In conclusion, AGB has and continues to play an important role in the treatment of morbid obesity. It offers reasonably good weight loss results with very little morbidity, and the future of the adjustable band is bright.

Bariatric Surgery Patients' Perceptions of Weight-Related Stigma in Healthcare Settings Impair Post-surgery Dietary Adherence

“…A range of research focused on bariatric patients has shown that people find adherence to the dietary recommendations very difficult in the long term (Hsu et al, 1997 , 1998 ; Elkins et al, 2005 ; Poole et al, 2005 ; van Hout et al, 2005 ; Toussi et al, 2009 ; Snyder et al, 2010 ; Sarwer et al, 2011 ; Chesler, 2012 ; Homer et al, 2016 ). After the initial 6–12 months post-surgery, as the physical limitations ease somewhat with time, adhering to new, drastically smaller portion sizes is believed to be the primary challenge for most of the men and women who undergo the surgery (MacLean et al, 1983 ; Miskowiak et al, 1985 ; Näslund et al, 1988 ; Andersen and Larsen, 1989 ; Lindroos et al, 1996 ; Malone and Alger-Mayer, 2004 ; Sjöström et al, 2004 ; Sarwer et al, 2008 ).…”

Obesidade ante et post cirurgia

“…A sensação de fome induzida por este tipo de prática é constante e o indivíduo sente a sua qualidade de vida reduzida. As complicações associadas a este tipo de cirurgia envolvem a dilatação da bolsa gástrica ou do esófago, a erosão e o deslizo da banda (Snyder et al, 2010). Actualmente, esta técnica é pouco realizada, somente em casos seleccionados, já que a longo prazo não é considerada a melhor opção (Lemos et al, 2005).…”

“…Actualmente, esta técnica é pouco realizada, somente em casos seleccionados, já que a longo prazo não é considerada a melhor opção (Lemos et al, 2005). Caso a banda deva ser removida, deve ser tido em consideração a conversão para um outro modelo cirúrgico, como por exemplo para o bypass, devido à grande probabilidade que estes pacientes têm de recuperar o peso perdido (Snyder et al, 2010).…”

Laparoscopic adjustable gastric band revisional surgery: a single surgeon series

“…Prevention of recognized early gastric band complications, including acute band obstruction, gastric perforation, bleeding and infection rely on meticulous surgical technique . Occasionally, surgical intervention in the early post‐operative period is required for adjustment or replacement of the device . Proximal pouch enlargements above the band including anterior, posterior and symmetrical dilatation, band erosion and access port or tubing failure are complications that may occur later .…”

“…9 Occasionally, surgical intervention in the early post-operative period is required for adjustment or replacement of the device. 10 Proximal pouch enlargements above the band including anterior, posterior and symmetrical dilatation, band erosion and access port or tubing failure are complications that may occur later. 11 The introduction of the pars flaccida approach has significantly reduced the rates of gastric band slippage.…”