This operation started in the mid-nineties with the appearance of two types of bands in the market: The American (Lap-band) and the Swedish (SAGB). More than 90,000 cases were done so far. Most surgeons performing the procedure are new to morbid obesity surgery. The procedure is very attractive to surgeons because it is very easy to perform. The principle of the operation is through placing a band around the upper stomach, that band is lined with an inflatable balloon that is connected with a tube to a metallic reservoir that is placed under the skin. Later on the skin is pierced with a long needle to access the metal reservoir and inflate the balloon and thus control the diameter of the band. The operation is done laparoscopically using 4-5 small incisions and with a one day hospital stay. The operation has the same principle as stomach stapling giving satiety after eating a small amount of food and it also has the same week point of inability to control sweet or high calorie fluid intake so that a sweet consuming individual can fail the operation and gain weight despite having the band in place. Results of the band are very controversial were there are many reports of good results (these usually are reported by band only surgeons) and also there are many bad results for the band (these are usually reported by surgeons who perform other forms of obesity surgery). The United States experience with the band reported poor weight loss as compared to the stomach bypass procedure and also reported an unacceptably high rate of complications and band removal. In our experience in Egypt we compared the 4 types of obesity operations and we were surprised to see very slow and poor weight loss with the adjustable band as compared to the stomach stapling, bypass or BPD operations. Also the incidence of complications with banding tends to increase with time.
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