Laparoscopic Adjustable Gastric Band Slippage Rates Following Laparoscopic Gastric Band Insertion: a Single Centre Experience.
INTRODUCTION
Laparoscopic adjustable gastric bands (LAGB) are placed around the superior aspect of the stomach to aid weight loss and co-morbidity resolution in morbidly obese patients. Slippage of the LAGB from its original position to lower in the fundus of the stomach leads to gastric obstruction, and sometimes ischaemia or perforation, necessitating LAGB repositioning or removal. This study aimed to identify the incidence of LAGB slippage, as well as predisposing factors that may influence its development.


METHODS
All LAGBs inserted at one centre, via a pars flaccida technique, by four Bariatric specialist consultants, were reviewed utilising a prospectively maintained Bariatric database, computer records and case notes review.


RESULTS
Seven hundred nineteen LAGBs were inserted and 33 slips treated; however, only 22 slips had their LAGB inserted at our centre (local slip rate 3.1 %). Multivariate analysis demonstrated a significant association between LAGB slip and younger median age at LAGB insertion (41 years slip vs. 45 years non-slip; p = 0.027), higher median total excess weight loss (64 % slip vs. 36 % non-slip; p < 0.001) and higher mean excess weight loss per month (2.41 % slip vs. 1.00 % non-slip; p < 0.001). There was no significant effect by sex, BMI at insertion or band type.


CONCLUSIONS
Band slips are associated with greater excess weight loss and younger age. Larger studies may be necessary to further elucidate the risk factors contributing to, and mechanisms of, band slippage.
['Skipworth|J R A|JR|', 'Fanshawe|A E|AE|', 'Hewitt|M|M|', 'Raptis|D A|DA|', 'Efthimiou|E|E|', 'Smellie|W J B|WJ|']
D000328:Adult D005260:Female D005548:Foreign-Body Migration D015391:Gastroplasty D006801:Humans D015994:Incidence D010535:Laparoscopy D008297:Male D008875:Middle Aged D009767:Obesity, Morbid D012307:Risk Factors D013270:Stomach D015431:Weight Loss
Laparoscopic Gastric band Band slippage LAGB Complications