Das laparoskopisch implantierte steuerbare Magenband – Beobachtungen und Entwicklungen

Abstract

Laparoscopically Implanted Adjustable Gastric Banding – Observations and Evolution In this article the current literature on the use of laparoscopic surgery for morbid obesity is evaluated to identify its status in current practice. We performed a systematic review of the literature, including papers published between January 1994 and December 2002. Within the peer-reviewed scientific literature, the published complication rate was found to be low. However, most of the communications were presented as case reports in abstracts or as oral communications during national and international conferences or congresses. The average age of patients having laparoscopic gastric banding for morbid obesity was 34.4 years. The most common postoperative complication of the adjustable gastric banding procedure was slippage. The conversion rates to open procedures in the first reports varied between 1.5 and 48%. Today it is lower than 1%. Improvements with respect to comorbid diseases were poorly reported although patient recovery benefits are well-known. Nine years after the first report of laparoscopic gastric banding, early and late complications has rarely been reported. This might reflect a lack of control following the introduction of this procedure. The majority of reports continue to be communications or poster presentations. The variable nature and content of the literature demonstrate the lack of standardization and the absence of an agreed core minimum data set. The late complication rate of laparoscopic gastric banding surgery for morbid obesity remains unclear. Until late complications of laparoscopic adjustable gastric banding and long-term data on outcomes become available, laparoscopic surgery for morbid obesity should be carried out only in bariatric centers.