New adjustable gastric bands available in the United States: a comparative study

Abstract

Background New gastric bands have been available for the past 3 years in the United States: Lap-Band AP (LBAP), Realize Band (RB), and Realize Band C (RBC). No RBC data have been previously published. The objective of the present study was to report our experience with 3 newer gastric bands in an experienced, private, U.S. bariatric surgery center. Methods Data were prospectively collected and retrospectively reviewed. The characteristics evaluated include age, body mass index (BMI), gender, percentage of excess weight loss, band fill volumes, and complications. Results From April 2007 through February 2010, 633 patients (mean age 42.3 ± 10.3 years) underwent laparoscopic band placement. The LBAP was placed in 384 patients (78% women, BMI 45.4 ± 6.9 kg/m 2), the RB in 167 patients (84% women, BMI 46.4 ± 7.9), and the RBC in 82 patients (76% women, BMI 46.1 ± 8.2). The corresponding mean 1-year percentage of excess weight loss was 44.4% ± 19%, 38.9% ± 16.2%, and 32.1% ± 16.1% (LBAP versus RB and RBC, P <.05), with a 91%, 90%, and 83% follow-up rate. The 2-year percentage of excess weight loss for the LBAP and RB patients was 52.5 ± 21.2 and 43.3 ± 21.3 ( P <.05), respectively, with a 76% and 67% follow-up rate. The corresponding mean band volumes at 1 year were 4.6, 7.6, and 10.2 mL, with 2%, 12%, and 38% of the bands filled more than the manufacturer's maximal volume capacity recommendation. The postoperative complications included slippages and erosions in .5% and .5% of the LBAP, .6% and 1.8% of the RB, and 1.2% and 0% of the RBC patients, respectively. Conclusion Of the new bands available in the United States, the LBAP provided significantly better weight loss in our private practice setting. The RBC patients had the least weight loss, with a high band-fill volume needed to achieve effective restriction.