SP2.1.2 Increasing Burden of Complications of Gastric bands on NHS Bariatric Services

Abstract

Abstract Background Approximately 40% of patients that undergo laparoscopic adjustable gastric band (LAGB) insertion for obesity experience long-term complications and a lack of weight loss. This has caused a surge in LAGB removal procedures under the NHS. We review patient outcomes for these procedures at our tertiary bariatric centre. Methods All LAGB removals performed between October 2012 and August 2021 were reviewed. Data was collected prospectively & analysed retrospectively for demographics, body mass index (BMI), surgical indications and postoperative complications. Results During the study period, a total of 178 patients underwent LAGB removal (93.8% female). Most bands were inserted out of province, done privately and patients’ mean BMI pre-operatively was 41.6. Indications for band removal included dysphagia (41.1%), band slippage or tubing damage (25.8%), pain (15.2%), obesity-related health condition (11.2%), infected/ leaking band (3.9%), and band erosion (2.8%). At LAGB removal, patients’ mean BMI was 37.0 – thus there was a mean decrease of 4.6 in BMI between index and removal operations. One LAGB removal case was converted to open. The mean length of stay for LAGB removal patients was 2.9 days. 12 patients had post-operative complications: wound infection (58.3%), peritonitis (25.0%), pneumonia (8.3%) and food ball in stomach (8.3%). 38 out of 178 (21.3%) patients then underwent revision bariatric surgery in the form of laparoscopic Roux-en-Y gastric bypass procedures. Conclusion Although most primary gastric banding procedures are performed privately, the number of removals under NHS services is increasing. LAGB removal can be successfully performed to ease debilitating symptoms with excellent symptom resolution and minimal peri-operative complications.