Lap-Band Outcomes Called Poor Over Time

More of the IMHO bariatric surgery malpractice.

Nearly half of patients undergoing laparoscopic gastric banding for obesity eventually needed to have the devices removed because of erosion or some other malfunction, researchers said.

Among 82 patients followed for at least 12 years after lap-band surgery at a single institution, 49 had at least one reoperation for complications or device failure, according to Jacques Himpens, MD, of Saint Pierre University Hospital in Brussels, and colleagues.

They also reported online in Archives of Surgery that 41 had the bands removed during follow-up, with 14 then undergoing Roux-en-Y gastric bypass surgery. In all but a few cases, inadequate weight loss or device breakdown was the reason for band removal...

They suggested that the patients lost to follow-up probably had lost little weight, insofar as regular postoperative evaluations and treatment are "a critical factor for success in bariatric procedures."

Among the 82 with follow-up data, 32 indicated they had suffered major complications. These included nine cases of pouch dilation (requiring band removal in six) and 23 instances of band erosion.

The latter was discovered after a mean of four years (SD 2.9) and led to band removal or gastric bypass surgery in 19 cases.

As one might expect, weight loss during follow-up was greatest in patients whose bands remained in place. From a baseline mean BMI of 42, the mean at follow-up was about 33 in patients retaining the bands, versus 37.5 in those whose bands were removed.

Himpens and colleagues also found that the prevalence of obesity-related illnesses remained the same or increased over time in the cohort:

Arterial hypertension: 25.6% at baseline, 29.5% at follow-up
Type 2 diabetes: 6.4% at baseline, 14.1% at follow-up
Treatment for obstructive sleep apnea: 2.6% at baseline, 7.7% at follow-up

Time to make this procedure go away.