Gastric banding in the treatment of morbid obesity

Background/Aims: Obesity appears to be an epidemic problem now. Thirty percent of men and 40% of women in the fifth decade are obese (>20% over ideal weight). Extreme obesity in itself decreases life expectancy and is associated with the early development of cardiopulmonary disorders, hypertension, diabetes and many other disorders. The non-operative treatment of extreme obesity rarely leads to permanent weight reduction. Various operative procedures such as verical banded gastroplasties, malabsorptive operations or gastric bandings have been suggested for the production of permanent weight loss. A relatively high incidence of morbidity following ''laparotomy'' procedures for obesity treatment prompted us to start laboratory studies in 1991 on laparoscopic gastric banding. Material and Methods: In June 1993 we performed the world's first ''laparoscopic'' gastric banding in a human, and since then, we have operated on, more than 60 patients using this method. Results: The 5-year mean post-operative weight loss of -37.4 kilograms, with significant blood pressure decreases at 1-year follow-up and with no significant changes noted in the levels of RBC, electrolytes and transaminase. Conclusion: The ''laparoscopic'' approach in gastric banding enabled us to shorten hospital stay and decrease post-operative complications significantly.