Frequency of adjustments and weight loss after laparoscopic adjustable gastric banding

Laparoscopic adjustable gastric banding is an effective procedure for weight loss. Long-term follow-up and band adjustments are crucial to achieve sustained weight loss, but the optimal frequency is unknown. We compare the weight loss of two patient groups adjusted at different frequencies. A 24-month analysis was conducted to 280 patients (156 from an academic center and 124 from an outpatient surgery center). Each center's patients were stratified into 6-month groups according to the length of follow-up. These groups were compared between the settings for average adjustments per month and percent excess weight loss (%EWL). Patient subgroup 0-6 months had 0.6 adjustments/month (adj/mo) and 18.3% EWL at AC compared to 0.7 adj/mo and 19.1% EWL at OC. Subgroup 6-12 months had 0.4 adj/mo and 27.2% EWL at AC compared to 0.5 adj/mo and 33.4% EWL at OC. Subgroup 12-18 months had 0.3 adj/mo and 25.3% EWL at AC compared to 0.5 adj/mo and 45.6% EWL at OC. Subgroup 18-24 months had 0.3 adj/mo and 30.9% EWL at AC compared to 0.3 adj/mo and 42.2% EWL at OC. Analysis of variance crossing 6-month groups with facility produced significant effects for groups (F = 15.52, df = 4.290, p < 0.001), center (F = 14.28, df = 1.290, p < 0.001), and the center-by-group interaction (F = 3.01, df = 4.290, p < 0.02). Our data suggest that more frequent adjustments result in increased EWL, but optimal frequency remains unknown. We believe that the difference noted between the clinics stems from accessibility to adjustments. Additional data, such as %EWL at smaller monthly intervals and the point of diminishing results, should be investigated in future studies.