Lap Band Long-term Outcome: A New Study from Switzerland

A well conducted study by a group of Swiss surgeons was recently published in Surgery for Obesity and Related Diseases (SOARD). A total of 405 Lap Band patients were retrospectively analyzed using prospectively collected data. The follow up rate was 85% and ranged from 8 to 18 years. One hundred patients exceeded 15-year follow-up.

The authors found that the majority of patients lost their band due to band intolerance defined or band slippage. Band intolerance occurred when patients developed reflux, dysphagia, food intolerance and abdominal pain not improving with band adjustment. Around 30% of evaluated patients maintained their bands and 15% of 334 patients had good to excellent weight loss outcomes.

The authors conclude that adjustable gastric banding should no longer be offered to obese patients. The evidence they present is the last nail in the Lap Band coffin. This is an important study with excellent long-term follow up rate. A restrictive device applied on the stomach to force patients to eat less and result in durable weight loss is a naïve assumption. Obstructing or restricting esophageal outflow can only result in complications like heartburn, food regurgitation, esophageal dysmotility and dilation. I have managed a number of Lap Band cases with significant esophageal dysmotility requiring complicated surgical repair and conversion to gastric bypass to remedy the condition.

Lap Band surgery, a procedure that had been rapidly and irrationally adopted, has failed as a bariatric and metabolic procedure. It is time for the FDA to withhold the device from the market. ASMBS has yet to publish a clear statement on Lap Band complications and ineffectiveness as a weight loss procedure. The evidence is overwhelmingly strong against Lap Band usage. I don’t see any indication for Lap Band use in our fight against obesity.