Laparoscopic adjustable gastric banded plication: evolution of procedure and 2-year results.

Background: Laparoscopic adjustable gastric banded plication (LAGBP) is a new restrictive bariatric procedure combining adjustable banding and greater curvature plication of the stomach. This study aimed to report the evolution of this surgical technique and analyze the surgical results.

Methods: Eighty patients who underwent LAGBP were enrolled in this study. The band-first technique was used in 50 patients from May 2009 to June 2011 and was then changed to the plication-first technique from July 2011 to October 2011. Patients' demographics and pre- and postoperative data, including complications and weight loss, were collected and analyzed.

Results: Eighty patients (26 men and 54 women) with a mean age of 30.75 ± 8.68 years and a mean body mass index of 38.05 ± 4.73 kg/m2 were evaluated with a mean follow-up of 10.52 (1-24) months. The average operation duration and hospital stay were 92.85 ± 35.86 min and 1.73 ± 1.04 days, respectively. No intraoperative complications or surgical mortality was observed in this series. Four (8%) postoperative complications occurred with the band-first technique and one (3%) with the plication-first technique. Mean excess weight loss (percentage) at 6, 12, 18, and 24 months were 42.59 ± 13.67, 56.38 ± 19.89, 57.59 ± 19.88, and 65.84 ± 17.36%, respectively. The frequency of band adjustment was 2.44 ± 2.21 times in 2 years.

Conclusions: In this present 2-year result, LAGBP using plication-first technique revealed fewer complications and good weight loss. Longer follow-up is still necessary to be accepted as a stand-alone bariatric procedure.