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Theodor Junginger - One of the best experts on this subject based on the ideXlab platform.
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Early results with a new telemetrically adjustable Gastric Banding.
Obesity surgery, 2007Co-Authors: Rudolf A. Weiner, Michael Korenkov, Esther Matzig, Sylvia Weiner, Woiteck K. Karcz, Theodor JungingerAbstract:It has already been demonstrated that laparoscopic adjustable Gastric Banding (LAGB) is a safe and effective alternative to other permanent bariatric surgery techniques. Although clinical complications have been managed through improvements in surgical techniques, port-related complications and adjustment process inefficiencies have persisted. To reduce and manage these issues, a new type of Gastric band has been developed which uses telemetric technology to eliminate the use of hydraulic ports and simplify the overall Gastric band adjustment procedure. From June 2005 to October 2005, 37 patients were implanted in two German academic centers with the Easyband® telemetrically adjustable Gastric band (Endoart S.A., Lausanne, Switzerland), using standard Gastric Banding laparoscopic technique. Prospective data was collected and analyzed for a minimum of 6 months on all morbidly obese patients who underwent laparoscopic telemetrically adjustable Gastric Banding. Data on 37 patients was analyzed.The mean percent excess weight loss was 10.2% at 1 month, 21.6% at 3 months, and 29.4% at 6 months. In 12 hypertensive patients, the systolic blood pressure decreased from 143 ± 24 mmHg at baseline to 131 ± 10 mmHg after 6 months. Diastolic pressure did not change significantly. In all 5 patients with diagnosed type 2 diabetes, the fasting blood glucose normalized after 6 months (135 mg/dl at baseline, 81 mg/dl at month 6). These early results of the new telemetrically adjustable Gastric Banding device indicate clinical safety and efficacy comparable to that achieved by other commercially available Gastric bands. Additional multi-center studies with long-term followup are recommended to confirm the benefits of telemetrically adjustable Gastric Banding.
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Early Results with a New Telemetrically Adjustable Gastric Banding
Obesity Surgery, 2007Co-Authors: Rudolf A. Weiner, Michael Korenkov, Esther Matzig, Sylvia Weiner, Woiteck K. Karcz, Theodor JungingerAbstract:Background It has already been demonstrated that laparoscopic adjustable Gastric Banding (LAGB) is a safe and effective alternative to other permanent bariatric surgery techniques. Although clinical complications have been managed through improvements in surgical techniques, port-related complications and adjustment process inefficiencies have persisted. To reduce and manage these issues, a new type of Gastric band has been developed which uses telemetric technology to eliminate the use of hydraulic ports and simplify the overall Gastric band adjustment procedure. Methods From June 2005 to October 2005, 37 patients were implanted in two German academic centers with the Easyband® telemetrically adjustable Gastric band (Endoart S.A., Lausanne, Switzerland), using standard Gastric Banding laparoscopic technique. Prospective data was collected and analyzed for a minimum of 6 months on all morbidly obese patients who underwent laparoscopic telemetrically adjustable Gastric Banding. Results Data on 37 patients was analyzed.The mean percent excess weight loss was 10.2% at 1 month, 21.6% at 3 months, and 29.4% at 6 months. In 12 hypertensive patients, the systolic blood pressure decreased from 143 ± 24 mmHg at baseline to 131 ± 10 mmHg after 6 months. Diastolic pressure did not change significantly. In all 5 patients with diagnosed type 2 diabetes, the fasting blood glucose normalized after 6 months (135 mg/dl at baseline, 81 mg/dl at month 6). Conclusion These early results of the new telemetrically adjustable Gastric Banding device indicate clinical safety and efficacy comparable to that achieved by other commercially available Gastric bands. Additional multi-center studies with long-term followup are recommended to confirm the benefits of telemetrically adjustable Gastric Banding.
Franz Aigner - One of the best experts on this subject based on the ideXlab platform.
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Results and Complications after Swedish Adjustable Gastric Banding—10 Years Experience
Obesity Surgery, 2009Co-Authors: Reinhard Mittermair, Franz Aigner, Sabine Obermuller, Alexander Perathoner, Michael Sieb, Raimund MargreiterAbstract:Background Bariatric surgery is currently the only effective treatment for morbid obesity. The main advantage of laparoscopic adjustable Gastric Banding is that this operation is minimally invasive to the stomach and adjustable to the patient’s needs. Few long-term studies on Swedish adjustable Gastric Banding (SAGB) have been published. We here report our 10-year experience with 785 SAGB procedures. Methods Between January 1996 and January 2006, 785 consecutive patients (81% women, 19% men) underwent laparoscopic SAGB. All data (demographic and morphologic, operative, and annual follow-up data) were prospectively collected in a computerized data bank. The postoperative follow-up program was performed largely by residents while 30 different surgeons performed the operation. Results Follow up data were available for 733 patients (98.3%); 52 patients (6.6%) were lost to follow-up. The median follow-up was 3.0 years (range, 1–10 years). The median total weight loss was 26 kg after 1 year and 40.5 kg after 8 years with a median EWL of 65.5% after 8 years. The median BMI decreased from 42.9 to 28.3 kg/m^2. A total number of 688 complications occurred in 396 patients (50.4%). The most common complications were esophagitis (28.8%), pouch dilation (15.3%), esophageal dilation (12.5%), port problems (11%), band migration (6.5%), and band leakage (6.4%). Overall, 251 reoperations (32%) were performed. There was no mortality. Conclusions From our 10-year experience, we can state that SAGB is an effective bariatric procedure for achieving weight loss. Because of the high complication and reoperation rate, it is necessary to select patients according to specific criteria for Gastric Banding.
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results and complications after swedish adjustable Gastric Banding 10 years experience
Obesity Surgery, 2009Co-Authors: Reinhard Mittermair, Franz Aigner, Sabine Obermuller, Alexander Perathoner, Michael Sieb, Raimund MargreiterAbstract:Background Bariatric surgery is currently the only effective treatment for morbid obesity. The main advantage of laparoscopic adjustable Gastric Banding is that this operation is minimally invasive to the stomach and adjustable to the patient’s needs. Few long-term studies on Swedish adjustable Gastric Banding (SAGB) have been published. We here report our 10-year experience with 785 SAGB procedures.
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Pregnancies after adjustable Gastric Banding.
Obesity surgery, 2001Co-Authors: Helmut Weiss, Hermann Nehoda, Burkhard Labeck, Katherine Hourmont, Christian Marth, Franz AignerAbstract:Background: We evaluated outcome of pregnancies of morbidly obese women who are within the first 2 years after laparoscopic adjustable Gastric Banding. Methods: 215 morbidly obese women of reproductive potential (age 18-45 years), who had agreed to remain on reliable contraceptives for 2 years after surgery, were retrospectively analyzed following bariatric surgery. Results: 7 unexpected pregnancies were observed. 5 pregnancies were full-term (3 vaginal and 2 cesarean deliveries). The birth weights ranged from 2110 g to 3860 g. 2 women had first trimester miscarriages. All Gastric bands were completely decompressed due to nausea and vomiting, resulting in further weight gain. 2 serious band complications were observed (1 intraGastric band migration and 1 balloon defect), which required re-operation. Conclusions: Pregnancy in morbidly obese women soon after adjustable Gastric Banding may occur unexpectedly during a period of weight loss. Prophylactic fluid removal from the band eliminates the efficacy of the obesity treatment. Moreover, this cohort shows an increased incidence of spontaneous abortions and band-related complications.
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aberrant left hepatic artery in laparoscopic Gastric Banding
Obesity Surgery, 2000Co-Authors: H Nehoda, Helmut Weiss, Monika Lanthaler, B Labeck, K Hourmont, P J Klingler, Franz AignerAbstract:BACKGROUND The aberrant left hepatic artery (ALHA) is an anatomic variation which may be an obstacle in the laparoscopic Gastric Banding operation. Based on our experience, our mission was to answer the questions: How frequently is an ALHA encountered? Is division necessary? Are there any additional complications in cases where the ALHA is preserved? METHODS In a prospectively collected database of 270 patients undergoing laparoscopic Gastric Banding in our unit, information including presence of an ALHA, clinical data, diagnostic work-up, operative reports, laboratory data, and follow-up data were collected. RESULTS In 48 patients (17.7%) (39 women, 9 men, mean age 39.2 years) an ALHA was observed. Hiatal dissection was not impaired in any of these patients, and none required division of the ALHA. In all but two cases, the band was placed above the ALHA, offering additional stability to the band positioning. In 2 patients (4.1%), the artery was injured during dissection and was divided due to ongoing bleeding. Twenty-two (45.8%) of the ALHAs were of intermediate or large size. Neither pouch dilatation nor band slippage occurred in the above-mentioned group. The two patients with divided hepatic arteries had no postoperative symptoms related to impaired liver function. CONCLUSIONS ALHA is not an uncommon finding during laparoscopic Gastric Banding and may be found in approximately 18% of patients. Division can nearly always be avoided and may be required only in selected cases due to bleeding. Patients do not experience clinical complications after division, although liver enzymes may be temporarily elevated, and no monitoring is necessary.
M Helena Cardoso - One of the best experts on this subject based on the ideXlab platform.
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Increase in Ghrelin Levels After Weight Loss in Obese Zucker Rats is Prevented by Gastric Banding
Obesity Surgery, 2007Co-Authors: Mariana P. Monteiro, Andreia Ribeiro, Ana F. Nunes, Mónica Mendes Sousa, J. Duarte Monteiro, Artur P. Águas, M Helena CardosoAbstract:Background Gastric Banding is thought to decrease appetite in addition to the mechanical effects of food restriction, although this has been difficult to demonstrate in human studies. Our aim was to investigate the changes in orexigenic signals in the obese Zucker rat after Gastric Banding.
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Rats submitted to Gastric Banding are leaner and show distinctive feeding patterns.
Obesity surgery, 2006Co-Authors: Mariana P. Monteiro, J. Duarte Monteiro, Artur P. Águas, M Helena CardosoAbstract:Background: Bariatric surgery is expanding to meet the global epidemic of morbid obesity, because this surgery is successful in achieving sustained weight loss. After having recently established a rat model of Gastric Banding, our aim now was to investigate the relative fat mass content and the feeding patterns of Gastric banded rats. Methods: Two groups of Wistar rats, submitted either to Gastric Banding or to sham surgery, were followed-up for 26 days regarding weight, daily food intake and feeding patterns both under resting conditions and when refed after fasting. Weight of the epididymal fat pad was used as a measure to evaluate changes in white adipose tissue in the rats. Results: 10 days after surgery and thereafter, rats submitted to Gastric Banding showed the same daily food intake that was observed in sham-operated rats. Nevertheless, Gastric banded rats kept lower body weights and were leaner than controls. These differences were associated with distinctive feeding patterns, both under resting conditions and when refed after fasting, suggesting that Gastric banded rats present a significant increase in feeding frequency when compared with controls. Conclusion: This data is the first experimental evidence that an increase in feeding frequency is associated with weight loss after Gastric Banding, even if there is no decrease in total energy intake. Thus, medical advice on the advantages of fractionating daily caloric intake into multiple meals is further supported by the herein new information obtained in an animal model of Gastric Banding.
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A rat model of restrictive bariatric surgery with Gastric Banding.
Obesity surgery, 2006Co-Authors: Mariana P. Monteiro, J. Duarte Monteiro, Artur P. Águas, M Helena CardosoAbstract:Background: Gastric Banding is a well established weight reduction operation that is effective in the treatment of severe obesity. Its metabolic and endocrine mechanisms of action, however, remain unclear. The aim of this study was to establish a rat model of Gastric Banding that would replicate the procedure performed in human obese patients. Methods: Male Wistar rats were submitted either to Gastric Banding (n=5) or sham Gastric Banding (n=4), and were followed for 21 days. Detailed description on how to perform Gastric Banding in rats are herein described. Results: The Wistar rats submitted to Gastric Banding showed a decrease in weight gain and food intake when compared to sham-operated rats.The cumulative weight gain during the 21 days after the surgical procedure was 143 ± 2.58 g for the Gastric banded rats and 162 ± 2.48 g for the sham-operated animals (P=0.001). The cumulative food intake was 329 ± 0.53 g for the Gastric banded rats and 380 ± 15.22 g for the sham-operated animals, also statistically significant (P=0.025). Conclusion: A rat model to study Gastric Banding is described. This model can now be used for experimental investigation of biochemical and molecular mechanisms of weight loss resulting from this type of surgery.
Paul E Obrien - One of the best experts on this subject based on the ideXlab platform.
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patients perspectives on laparoscopic adjustable Gastric Banding lagb aftercare attendance qualitative assessment
Obesity Surgery, 2014Co-Authors: Leah Brennan, Irena Moroshko, Narelle Warren, Wendy A Brown, Paul E ObrienAbstract:Background Despite recognition of the importance of laparoscopic adjustable Gastric Banding (LAGB) aftercare for optimal surgical outcomes and the failure of some patients to attend regularly, factors influencing LAGB aftercare attrition have not been thoroughly examined in the literature.
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laparoscopic adjustable Gastric Banding in severely obese adolescents a randomized trial
JAMA, 2010Co-Authors: Paul E Obrien, Wendy A Brown, Cheryl Laurie, Stewart Skinner, Susan M Sawyer, Friederike Veit, Eldho Paul, Paul R Burton, Melanie Anne Mcgrice, Margaret Louise AndersonAbstract:Context Adolescent obesity is a common and serious health problem affecting more than 5 million young people in the United States alone. Bariatric surgery is being evaluated as a possible treatment option. Laparoscopic adjustable Gastric Banding (Gastric Banding) has the potential to provide a safe and effective treatment. Objective To compare the outcomes of Gastric Banding with an optimal lifestyle program on adolescent obesity. Design, Setting, and Patients A prospective, randomized controlled trial of 50 adolescents between 14 and 18 years with a body mass index (BMI) higher than 35, recruited from the Melbourne, Australia, community, assigned either to a supervised lifestyle intervention or to undergo Gastric Banding, and followed up for 2 years. The study was performed between May 2005 and September 2008. Main Outcome Measures Weight loss. Secondary outcomes included change in metabolic syndrome, insulin resistance, quality of life, and adverse outcomes. Results Twenty-four of 25 patients in the Gastric Banding group and 18 of 25 in lifestyle group completed the study. Twenty-one (84%) in the Gastric Banding and 3 (12%) in the lifestyle groups lost more than 50% of excess weight, corrected for age. Overall, the mean changes in the Gastric Banding group were a weight loss of 34.6 kg (95% CI, 30.2-39.0), representing an excess weight loss of 78.8% (95% CI, 66.6%-91.0%), 12.7 BMI units (95% CI, 11.3-14.2), and a BMI z score change from 2.39 (95% CI, 2.05-2.73) to 1.32 (95% CI, 0.98-1.66). The mean losses in the lifestyle group were 3.0 kg (95% CI, 2.1-8.1), representing excess weight loss of 13.2% (95% CI, 2.6%-21.0%), 1.3 BMI units (95% CI, 0.4-2.9), and a BMI z score change from 2.41 (95% CI, 2.21-2.66) to 2.26 (95% CI, 1.91-2.43). At entry, 9 participants (36%) in the Gastric Banding group and 10 (40%) in the lifestyle group had the metabolic syndrome. At 24 months, none of the Gastric Banding group had the metabolic syndrome (P = .008; McNemar χ 2 ) compared with 4 of the 18 completers (22%) in the lifestyle group (P = .13). The Gastric Banding group experienced improved quality of life with no perioperative adverse events. However, 8 operations (33%) were required in 7 patients for revisional procedures either for proximal pouch dilatation or tubing injury during follow-up. Conclusions Among obese adolescent participants, use of Gastric Banding compared with lifestyle intervention resulted in a greater percentage achieving a loss of 50% of excess weight, corrected for age. There were associated benefits to health and quality of life. Trial Registration ANZCTR Identifier: 12605000160639
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symmetrical pouch dilatation after laparoscopic adjustable Gastric Banding incidence and management
Obesity Surgery, 2008Co-Authors: Wendy A Brown, Paul E Obrien, Paul R Burton, Margaret Louise Anderson, John Dixon, Anna Korin, Geoffrey S HebbardAbstract:Background Laparoscopic adjustable Gastric Banding (LAGB) has commonly been complicated by the problem of band slippage or prolapse. Since popularization of the pars flaccida approach and improved anterior fixation, it is our impression that the problem of symmetrical dilatation of the proximal Gastric pouch has become more important.
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birth outcomes in obese women after laparoscopic adjustable Gastric Banding
Obstetrics & Gynecology, 2005Co-Authors: John Dixon, Maureen Elizabeth Dixon, Paul E ObrienAbstract:OBJECTIVE:This prospective study sought to examine the outcomes of 79 consecutive first pregnancies (> 20 weeks of gestation) in women following laparoscopic adjustable Gastric Banding (LAGB) for severe obesity.METHODS:The 79 women are from a cohort of 1,382 consecutive patients. The prospectively c
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laparoscopic adjustable Gastric Banding in the treatment of morbid obesity
Archives of Surgery, 2003Co-Authors: Paul E Obrien, John DixonAbstract:The epidemic of obesity requires an intervention that is both effective and broadly acceptable. Conventional medical programs have been ineffective. Traditional surgical approaches, such as Gastric bypass and biliopancreatic diversion, are accepted by less than 1% of the severely obese each year. Laparoscopic adjustable Gastric Banding (LAGB) has been in clinical use for 8 years and it is timely to look at the developments in technique and to look at the outcomes for safety, effectiveness, and acceptability. Data are based on our clinical experiences and research reports derived from 1145 patients treated to date by laparoscopic adjustable Gastric Banding. We have also drawn on the published literature and on a systematic review of the literature about LAGB published by the Australian Safety and Efficacy Register of New Interventional Procedures–Surgical. Generally reports that have included more than 100 patients and 3 or more years of follow-up have been selected. Laparoscopic adjustable Gastric Banding has proved to be a safe procedure, 7 to 10 times safer than Gastric bypass in terms of mortality, and associated with few perioperativecomplications.Lateeventshavebeenmorefrequentwithprolapseofthestomachthrough the band occurring in 15% of our initial patients and erosion of the band into the stomach in 3.2% of our initial patients. Both complications are treatable laparoscopically and have become less common with modifications of technique. Weight loss is gradual but progressive over the first 2 years and has stabilized at about 50% of excess weight lost for the next 4 years. There are major associated improvementsinthemultiplecomorbiditiesofobesityincludingtype2diabetesmellitus(DM),asthma, hypertension,dyslipidemia,asthma,gastroesophagealrefluxdisease,sleepdisorderedbreathing,comorbidities of pregnancy, and the quality of life (QOL). Laparoscopic adjustable Gastric Banding has several attributes that potentially will enable it to overcome the community’s resistance to bariatric surgery. It has proved to be safe. It is highly effective in achieving good weight loss, major improvements in health, and improved QOL. Because of the laparoscopic placement, adjustablity, and the easy reversibility, LAGB can provide these benefits in a gentle and safe way.
Reinhard Mittermair - One of the best experts on this subject based on the ideXlab platform.
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Long-term follow-up evaluation of revisional Gastric bypass after failed adjustable Gastric Banding
Surgical Endoscopy, 2013Co-Authors: Alexander Perathoner, Matthias Zitt, Monika Lanthaler, Johann Pratschke, Matthias Biebl, Reinhard MittermairAbstract:Background Disappointing long-term results, frequent band failure, and high rates of band-related complications increasingly necessitate revisional surgery after adjustable Gastric Banding. Laparoscopic conversion to Gastric bypass has been recommended as the procedure of choice. This single-center retrospective study aimed to evaluate the long-term results of revisional Gastric bypass after failed adjustable Gastric Banding. Methods The study included 108 consecutive patients who underwent laparoscopic conversion of Gastric Banding to Gastric bypass from 2002 to 2012. Indications for surgery, operative data, weight development, morbidity, and mortality were analyzed. The median follow-up period was 3.4 years (maximum, 10 years). Results The most common indications for band removal were band migration, insufficient weight loss, and pouch dilation. The median interval between Gastric Banding and Gastric bypass was 6.6 years. In 52 % of the cases, band removal and Gastric bypass surgery were performed simultaneously as a single-stage laparoscopic procedure. The early postoperative morbidity rate was 10.2 %. The body mass index before Gastric Banding (43.3 kg/m^2) decreased significantly to 37.9 kg/m^2 before Gastric bypass and to 28.8 kg/m^2 5 years after Gastric bypass. Conclusions This is the first report on the long-term outcome after conversion of failed adjustable Gastric Banding to Gastric bypass. Findings have shown revisional Gastric bypass to be a feasible bariatric procedure particularly for patients with insufficient weight loss that guarantees a constant and long-lasting weight loss.
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Results and Complications after Swedish Adjustable Gastric Banding—10 Years Experience
Obesity Surgery, 2009Co-Authors: Reinhard Mittermair, Franz Aigner, Sabine Obermuller, Alexander Perathoner, Michael Sieb, Raimund MargreiterAbstract:Background Bariatric surgery is currently the only effective treatment for morbid obesity. The main advantage of laparoscopic adjustable Gastric Banding is that this operation is minimally invasive to the stomach and adjustable to the patient’s needs. Few long-term studies on Swedish adjustable Gastric Banding (SAGB) have been published. We here report our 10-year experience with 785 SAGB procedures. Methods Between January 1996 and January 2006, 785 consecutive patients (81% women, 19% men) underwent laparoscopic SAGB. All data (demographic and morphologic, operative, and annual follow-up data) were prospectively collected in a computerized data bank. The postoperative follow-up program was performed largely by residents while 30 different surgeons performed the operation. Results Follow up data were available for 733 patients (98.3%); 52 patients (6.6%) were lost to follow-up. The median follow-up was 3.0 years (range, 1–10 years). The median total weight loss was 26 kg after 1 year and 40.5 kg after 8 years with a median EWL of 65.5% after 8 years. The median BMI decreased from 42.9 to 28.3 kg/m^2. A total number of 688 complications occurred in 396 patients (50.4%). The most common complications were esophagitis (28.8%), pouch dilation (15.3%), esophageal dilation (12.5%), port problems (11%), band migration (6.5%), and band leakage (6.4%). Overall, 251 reoperations (32%) were performed. There was no mortality. Conclusions From our 10-year experience, we can state that SAGB is an effective bariatric procedure for achieving weight loss. Because of the high complication and reoperation rate, it is necessary to select patients according to specific criteria for Gastric Banding.
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results and complications after swedish adjustable Gastric Banding 10 years experience
Obesity Surgery, 2009Co-Authors: Reinhard Mittermair, Franz Aigner, Sabine Obermuller, Alexander Perathoner, Michael Sieb, Raimund MargreiterAbstract:Background Bariatric surgery is currently the only effective treatment for morbid obesity. The main advantage of laparoscopic adjustable Gastric Banding is that this operation is minimally invasive to the stomach and adjustable to the patient’s needs. Few long-term studies on Swedish adjustable Gastric Banding (SAGB) have been published. We here report our 10-year experience with 785 SAGB procedures.