Researchers from Legacy Good
Samaritan Obesity Institute announced today the results from a 5-year study
of the safety of laparoscopic adjustable gastric banding (LAGB) compared to
laparoscopic Roux-en Y gastric bypass (LRYGB), two bariatric surgical
procedures performed in the United States for the treatment of morbid
obesity. All patients undergoing LAGB received the LAP-BAND(R) System,
which is the only FDA-approved adjustable implant device for individualized
weight loss. The study, which was published in the recent issue of Surgery
for Obesity and Related Diseases(1), found that the LAP-BAND(R) System
results in significantly fewer complications, shorter operative times, and
shorter hospital stays when compared with LRYGB.
"Given the lack of comparative data available from experienced
institutions that frequently perform both laparoscopic adjustable gastric
banding and laparoscopic Roux-en Y gastric bypass, we believe this study
provides important insights for both bariatric surgeons and their patients
on the safety of two of the most common surgical treatment options for
obesity," explained Emma J. Patterson, M.D., F.R.C.S.C., F.A.C.S., Medical
Director of the Legacy Good Samaritan Obesity Institute and lead
investigator of the study. "Previously, making comparisons between these
procedures has been challenging, as most reports of surgical outcomes have
been from institutions which often favor one procedure over the other."
The Legacy Good Samaritan Obesity Institute study was based on a
prospectively maintained database and included a total of 898 severely
obese patients with either a Body Mass Index (BMI) of 40 or more or a lower
BMI of 35 or more with at least one obesity-related co-morbidity, such as
sleep apnea, diabetes, or hypertension. BMI is a weight-for-height measure;
18.5- 24.9 is considered "normal," 25-29.9 "overweight," and 30 and above
as varying degrees of "obese." All procedures were performed at the
Institute between October 2000 and October 2005. Of the 898 patients, 492
(55%) underwent LRYGB and 406 (45%) underwent laparoscopic adjustable
gastric banding.
About the Study Findings and Adjustment of Patient Risk
While patients were generally able to choose the procedure they
preferred, higher-risk patients were recommended for the LAP-BAND(R) System
given its established lower risk of perioperative morbidity and mortality.
As a result, LAP-BAND(R) System patients were significantly older, heavier,
and had a significantly greater prevalence of sleep apnea compared to the
patients in the LRYGB group. Additionally, there were more men in the
LAP-BAND(R) System group than the LRYGB group.
However, even after adjusting for the differences in patient risks of
the two groups before surgery, the researchers found that the LAP-BAND(R)
System procedure was associated with half the rate of potentially
life-threatening complications compared to LRYGB (p < 0.05). LAP-BAND(R)
System patients also experienced about two-thirds the overall complication
rate of LRYGB patients, or 24 percent vs. 32 percent (p
While comparison of weight loss was not the focus of this study, Dr.
Patterson noted that both groups lost significant amounts of weight.
About Legacy Good Samaritan Obesity Institute
The Legacy Good Samaritan Obesity Institute is designed to help
patients manage their weight and change their lives. A multi-specialty team
which is comprised of surgeons, psychologists, dietitians, nurses, patient
educators, support groups, insurance coordinators and exercise specialists,
offer comprehensive care. The Institute recognizes the special needs of
obese patients and features extra-wide doors and chairs and power-assisted
tables. In addition, Legacy Good Samaritan Hospital has specialized
equipment for severely overweight patients, such as beds, waiting room
chairs, wheelchairs, recliners and stretchers.
The Legacy Good Samaritan Obesity Institute and Oregon Weight Loss
Surgery, the physician practice that leads the Institute, are certified as
an American Society for Bariatric Surgery (ASBS) Center of Excellence. This
designation recognizes the program for its record of favorable outcomes in
bariatric surgery.
(1) Jan JC, Hong D, Bardaro SJ, July LV, Patterson EJ. Comparative
study between laparoscopic adjustable gastric banding and laparoscopic
gastric bypass: single-institution, 5-year experience in bariatric surgery.
Surgery for Obesity and Related Diseases 2007, 3(1): 42-50.
Legacy Good Samaritan Obesity Institute
Legacy Good Samaritan Obesity Institute