Invited Commentary
December 2014

The Beginning of the End for Laparoscopic Banding

Author Affiliations
  • 1Department of Surgery, University of Michigan, Ann Arbor

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Surg. 2014;149(12):1287-1288. doi:10.1001/jamasurg.2014.1717

For many years, laparoscopic gastric bypass and adjustable gastric banding were the only 2 bariatric procedures performed by most bariatric surgeons. The trade-offs for the 2 procedures were seemingly straightforward: gastric bypass had higher risks but more weight loss; the laparoscopic band was safer but had lower weight loss. However, emerging evidence from single-center studies challenge this understanding, suggesting that adjustable gastric banding may not be as safe as we thought, especially when considering long-term outcomes. Many centers report that adjustable gastric banding is associated with high subsequent operation rates, and even laparoscopic band removal, for weight loss failure, slippage, erosion, and obstructive symptoms.1 This concerning trend in long-term safety and effectiveness, coupled with the emergence of sleeve gastrectomy, may be the beginning of the end of adjustable gastric banding.

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