Laparoscopic Silicone Adjustable Gastric Band; Initial Experience in Finland

Background: The Swedish adjustable gastric band (SAGB) was introduced in 1985 and rapidly gained popularity.Today more than 21,000 gastric banding procedures have been performed in Europe. The reported results of gastric banding operations are mainly good, although the method is not without controversies and risks. We report here our initial experience with the SAGB. Methods: 60 patients (44 women, 16 men) were treated surgically for morbid obesity between the years 1996 and 1999, with SAGB. Median age of the patients was 44 years (range 21-64) and preoperative median Body Mass Index (BMI, kg/m2) was 45 (range 35-55). 3 patients were operated by an open approach, and the remaining 57 laparoscopically. Results:Operative time was 62-206 minutes (median 97 minutes). Only one operation was converted to open approach (1.8%), due to extensive adhesions. No intraoperative complications occurred. At 1 year follow-up, mean weight loss was 30 kg, mean excess weight loss was 50%, and median BMI was 35. 4 patients have been reoperated so far (6.7%) due to slippage of the band (2 patients), infection of the band (1 patient), and leaking of the filling system (1 patient). Median postoperative hospital stay was 3 days (range 2-53). Mortality was 0%. Immediate postoperative mor- bidity-rate was 12% (7/60), although serious morbidity occurred in only 1 patient (1.7%). Conclusions: Laparoscopically placed adjustable gastric band is a good option for the morbidly obese patient.