Five-Year Study of Morbidly Obese Finds Significant Benefits of the LAP-BAND Procedure Over Laparoscopic Gastric Bypass

SAN FRANCISCO – The LAP-BAND System is less invasive, less risky than laparoscopic gastric bypass, according to a five-year study comparing the two most common weight-loss surgery procedures for the seriously overweight presented at this year's American Society for Bariatric Surgery meeting by Emma Patterson, MD, the senior investigator of the study and Director of Oregon Weight Loss Surgery, LLC, in Portland, Ore.

"This was one of the first comparative studies of LAP-BAND and laparoscopic gastric bypass patients conducted by a single institution," said Patterson. "It is significant to note that at the five-year mark there is no difference in the weight-loss results between the LAP-BAND and laparoscopic gastric bypass patients, yet the gastric bypass has a much greater risk of operative complications." The study is an extension of a three-year study conducted by Legacy Health System published two years ago. The study concludes:

-- LAP-BAND patients have shorter operative time, less blood loss and shorter hospital stay compared with laparoscopic gastric bypass patients

-- LAP-BAND is less invasive with less perioperative risk to the patient

-- LAP-BAND patients have decreased complication rates

Additional results of the study indicate that patients undergoing laparoscopic gastric bypass had statistically significant greater weight loss up to four years, but at five years, there was no statistical difference in percent excess weight loss between laparoscopic gastric bypass and LAP-BAND.

The study also concluded that laparoscopic gastric bypass patients had significantly more major complications than LAP-BAND patients (10 percent vs. 5 percent, respectively). This observation was substantially different from the finding in the three-year report, where no significant difference in major complications appeared between laparoscopic gastric bypass and LAP-BAND patients.

As morbid obesity continues to be a global health problem, bariatric surgery remains the only viable, consistent form of weight loss for this patient population. "With the LAP-BAND System, there is now a safer, less invasive and more acceptable surgical option for patients suffering from the emotional and physical impact of being seriously overweight," added Patterson.

The study compared a consecutive series of patients who underwent LAP-BAND (406) and LRYGB (492) for morbid obesity over a five-year period in a single institution. Most patients were able to choose between the LAP-BAND and laparoscopic gastric bypass procedures unless they were determined to be high risk (higher age, sex, male, super-super-obesity ((BMI greater than or equal to 60 kg/m2)), and presence of significant cardiopulmonary disease). All patients' age, sex, BMI, complications, mortality and excess weight loss (EWL) were examined. The LAP-BAND group had a higher mean preoperative BMI, and the LAP-BAND group had more patients with BMI greater than or equal to 60 kg/m2 (14 vs. 9 percent; P < 0.05).

All patients underwent pre-operative evaluations by a psychologist, nutritionist, sleep study and laboratory evaluation at the Legacy Good Samaritan Obesity Institute. Prior to surgery, patients were instructed to maintain a low-fat, low-carbohydrate diet and encouraged to lose at least 5 percent of their initial body weight. Postoperatively, LAP-BAND patients were seen at three and six weeks, monthly for the first six months, bi-monthly for the next six months, every three months for the second year, and then yearly thereafter. LRYGB patients were seen at three weeks after surgery, then every three months during the first year, every six months during the second year, and yearly thereafter.

Based in Portland, Oregon, Oregon Weight Loss Surgery, LLC is nationally recognized as a Center of Excellence in Bariatric Surgery. The practice is focused on laparoscopic weight-loss surgery and provides a comprehensive weight-loss program. The center is a leader in clinical research in bariatric surgery.

Source: Oregon Weight Loss Surgery, LLC