Laparoscopic Adjustable Gastric Banding (LAGB)

Abstract

Obesity has reached epidemic proportions worldwide and is often associated with metabolic disorders, such as type 2 diabetes, hypertension, and dyslipidemia, which increase the risk of cardiovascular disease. Bariatric surgery is known to be the most effective and long-lasting treatment for obesity and its comorbidities. Laparoscopic adjustable gastric banding (LAGB) is a minimally invasive operation that is being performed increasingly since it was introduced in the early 1990s. In Asia/Pacific, LAGB held steady from 2003 (80.4 %) to 2008 (82.5 %) and then fell in 2011 (32.6 %) [1]. However, considering the number of the LAGB performed in private clinic, it is still one of the most frequently performed bariatric procedures for morbid obesity. It is a safe procedure, easy to perform, reversible, and effective. Unlike other bariatric surgical procedures such as sleeve gastrectomy or gastric bypass, which alter the anatomy of the alimentary tract, LAGB is essentially a restrictive procedure that limits food capacity. These limits can be adjusted by injecting saline into the band system through a reservoir port, which alters the stoma diameter. With the adequately adjusted stoma, patients fitted with gastric band can be satisfied with small amount of nutritious food and resulting weight loss. A systematic review shows substantial and similar long-term weight losses for LAGB and other bariatric procedures [2]. Although minor (access port, pouch, infection) and major (slippage, erosion) complications of LAGB are increasingly reported recently, proper surgical technique and intensive patient education with good aftercare program can minimize the incidence of these complications.