A comparison of laparoscopic adjustable gastric band and laparoscopic sleeve gastrectomy: a single surgeon's...

Laparoscopic adjustable gastric band (LAGB) has been a popular form of surgical weight loss in New Zealand but is now being neglected in preference of the laparoscopic sleeve gastrectomy (LSG). Arguments for each operation have focused on differences in weight loss and complication rates. The aim of this study is to compare the results of these two techniques from a single surgeon's practise.

A non-randomised, observational study comparing patients undergoing either LAGB or LSG by a single surgeon.

There were 228 patients who had either a LAGB (94 patients, mean age 45.1 plus or minus 11.9 years, mean BMI 42.2 plus or minus 7.1 kg/m2) or a LSG (134 patients, mean age 44.8 plus or minus 9.11 years, mean BMI 50.2 plus or minus 9.0 kg/m2) between October 2009 and April 2014. The 2-year mean percent excess body weight loss for the LAGB group was 46.1 plus or minus 27.8% compared to 72.1% plus or minus 20.9% for the LSG group (P<0.0001). There were 19 patients (20%) that required 29 reoperations following LAGB, most commonly for gastric prolapse (mean 22.8 plus or minus 13.8 months postop). In contrast, there were 4 patients (3%) that required reoperation following LSG (2 haemorrhage, 1 staple-line leak and 1 check laparoscopy) and 2 patients (1%) that required gastroscopy for sleeve spasm. Reoperation rate was significantly greater for LAGB than LSG (p<0.0001).

In this current series there was a significantly reduced level of weight loss but higher complication rate following LAGB when compared to LSG. Despite the limitations of this study, the results may explain why LSG has gained preference over LAGB in recent years.