Background
Gastric banding is a restrictive type of surgery in which a silicone band is placed around the top portion of the stomach. The band generates a small pouch with limited volume which will provide an early and prolonged feeling of satiety; additionally, the band slows the passage of food from the pouch to the lower part of the stomach, thus leading to decreased food intake and subsequent weight loss.
This procedure is most commonly done using the laparoscopic minimally invasive approach.
A single-surgeon study by Furbetta et al found a mean excess weight loss of 49%, 52.6%, and 59.2% at 10-, 15-, and 20-year follow-up, respectively, after laparoscopic adjustable gastric banding.
A report by Hutter et al found that laparoscopic adjustable gastric banding has lower risk-adjusted morbidity, readmission, and reoperation/intervention rates than laparoscopic sleeve gastrectomy, laparoscopic Roux-en-Y gastric bypass, and open Roux-en-Y gastric bypass.
A study by Shimada et al, however, indicated that in obese adults with cardiovascular disease, the rate of emergency department visits or unplanned hospitalizations (ie, acute care use) is lower in those who undergo gastric bypass than in patients treated with gastric banding, over the first 2 postoperative years. For example, the adjusted rate ratio in the study for the first 7-12 months was 0.77, dropping further over time.