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Sunday 17 March 2013

Weight Loss Surgery


Lap-Band Shown Effective for Long-Term Weight Loss
(continued)
Fewer Lap-Band Surgeries Performed

Clements says just five of the 360 weight loss surgeries performed at Vanderbilt last year were Lap-Band procedures.

“We have essentially stopped doing this operation,” he says. “The sleeve and the bypass are just better for helping people lose weight and keep it off. That’s what we are seeing in our patients and that’s what the data are telling us.”

A 2011 study from Belgium found that the bands eroded in 1 in 3 patients, while 60% required additional surgeries.

And a study published last year that compared banding to bypass surgery found that bypass patients lost more weight and kept it off over six years and had fewer complications.

Four years ago, as many as 40% of weight loss surgeries performed at Lenox Hill Hospital in New York involved gastric banding, says Mitchell Roslin, MD, who is chief of obesity surgery.

Today, the figure is closer to 3%.

“Last year we took out 80 bands and converted them to other procedures,” he says. “Patients do well in the short term, but they tend to have problems later on.”

Banding Good Option for Some

American Society for Metabolic & Bariatric Surgery President Jaime Ponce, MD, confirms that fewer Lap-Band surgeries are being performed in the U.S.

Allergan’s sales related to its Lap-Band system reportedly fell from close to $300 million in 2011 to about half that figure last year, and last fall the company announced that it was looking to sell its weight loss surgery division.

But Ponce says the surgery is still a good option for some patients.

“The band is a device that requires a lot of maintenance and multiple adjustments, and one problem is that our insurance system is not set up to pay for this,” he says.

He says gastric banding is much more popular and widely performed than gastric bypass in Australia.

“In Australia, aftercare is covered by national insurance, so patients don’t have to worry about paying for adjustments,” Ponce says.

And there are plenty of gastric banding success stories here in America, including New York Jets head coach Rex Ryan, who lost more than 100 pounds after having the procedure in March of 2010.

Ponce says patients who understand that gastric banding will require careful compliance and frequent follow-up visits to their doctor can achieve good results with the gastric banding surgery.

“Patients need to be followed, preferably every month or so,” he says. “If your surgeon doesn’t offer this kind of follow up, you need to go somewhere else.”

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