Mini-Gastric Bypass

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MGB outperforms Laparoscopic Adjustable Silicone Gastric Banding Versus Vertical Banded Gastroplasty:

Outcomes	LAP-BAND�	VBG	MGB
Operative Time	65 min.	94 min.	38 min.
Hospital Stay	3.7 days	6.6 days	1.2 days
Complications	6.1%	9.8%	5.4%
Excess Weight Lost	59%	63%	80%

From Annals of Surgery

Laparoscopic Adjustable Silicone Gastric Banding Versus Vertical Banded Gastroplasty in Morbidly Obese Patients: A Prospective Randomized Controlled Clinical Trial

Posted 12/18/2003

Mario Morino, MD; Mauro Toppino, MD; Gisella Bonnet, MD; Gianmattia del Genio, MD

Abstract

Objective: To compare, in a prospective, randomized, single-institution trial laparoscopic adjustable silicone gastric banding (LASGB) with laparoscopic vertical banded gastroplasty (LVBG) in morbidly obese patients.
Summary Background Data: LASGB is a simple and safe procedure, but some reports have suggested disappointing long-term results. Despite the recent widespread use of LASGB, there are no prospective nor randomized trials comparing LASGB with other laparoscopic procedures.
Methods: A total of 100 morbidly obese patients, with body mass index (BMI) 40 to 50 kg/m², without compulsive eating, were randomized to either LASGB (n = 49) or LVBG (n = 51). Minimum follow-up was 2 years (mean 33.1 months).

Results: There were no deaths or conversions in either group.

Mean operative time was 94.2 minutes in LVBGs and 65.4 in LASGBs (P < 0.05).

Early morbidity rate was lower in LASGBs (6.1%) versus LVBGs (9.8%) (P = 0.754).

Mean hospital stay was shorter in LASGBs versus LVBGs: 3.7 days versus 6.6 (P < 0.05).

Late complications rate in LVBGs was 14% (7 of 50) and in LASGBs 32.7% (16 of 49) (P < 0.05).

The most frequent complication was the slippage of the band (18%). Late reoperations rate in LVBGs was 0% (0 of 50) versus 24.5% (12 of 49) in LASGBs (P < 0.001).

Excess weight loss in LVBGs was, at 2 years, 63.5% and, at 3 years, 58.9%; in LASGBs, excess weight loss, respectively, was 41.4% and 39%.

BMI in LVBGs was, at 2 years, 29.7 kg/m² and, at 3 years, 30.7 kg/m²; in LASGBs, BMI was 34.8 kg/m² at 2 years and 35.7 kg/m² at 3 years.

According to Reinhold's classification,
a residual excess weight <50% was achieved, at 2 years, in
74% of LVBG and
35% of LASGB (P < 0.001).

Conclusions: This study demonstrates that, in patients with BMI 40 to 50 kg/m², LASGB requires shorter operative time and hospital stay but LVBG is more effective in terms of late complications, reoperations, and weight loss.

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Addresses: Address: *** CLOS West: Dr. Rutledge / CELOS, 98 E Lake Mead Parkway, Suite 302, Henderson NV 89015, Telephone: 702-714-0011 Fax: 702-456-1173, Email: DrR@clos.net, Everyone@clos.net or CLOSLasVegas@clos.net *** CLOS Florida: 40124 Highway 27, Suite 203, Davenport, FL 33837, Flo Ballengee 863-899-3463, Flo@clos.net, Dr. Peraglie 407-922-3424 DrP@clos.net

Warning: Gastric Bypass Surgery is a MAJOR surgical procedure. It can be associated with significant risks and complications, up to and including death. Weight loss surgery is a rapidly developing area of medicine. Bariatric surgery is filled with controversy. It is very important to take a careful and deliberate approach to considering surgery for the treatment of obesity.

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