Laparoscopic adjustable gastric banding: is there a learning curve?

To be certified for laparoscopic placement of adjustable gastric banding, surgeons must have advanced laparoscopic experience. Despite previous exposure to other kinds of laparoscopy, there may a learning curve specific to Lap-Band placement.

Sixty consecutive patients were prospectively separated into two groups: the first 30 patients operated on (group 1) and the second 30 patients operated on (group 2).

Both groups were similar statistically in regard to gender, age, and body mass index. Operative time for group 1 was 79 +/- 31.1 min. There were 11 (37%) complications in 10 patients. Operative time for group 2 was 59 +/- 19.9 min. There were two complications (7%). All operations were completed laparoscopically. Operative time was significantly lower in group 2 ( t-test; p = 004). Complications were also significantly lower (chi-square; p = 0.005). The number of reoperations was also reduced and approached statistical significance (chi-square; p = 0.054). Readmissions, although reduced, were not statistically significant. There were no deaths in either group.

Despite a surgeon's history of advanced laparoscopic experience, there is a definite learning curve associated with the laparoscopically placed adjustable gastric band.