Laparoscopic Banded Bariatric Surgery

Laparoscopic banded bariatric surgery (LBBS) is an adjunct to enhance weight loss maintenance by implantation of a prosthesis around the gastric pouch formed in a bariatric metabolic operation. LBBS uses a nonadjustable ring/band that minimizes the dilatory tendency that is part of the natural history of operations created with a limiting gastric pouch to cause weight loss. Placing a ring/band enhances restriction, gives a sense of fullness, and ensures forced compliance mechanisms of the bariatric operation. The principle of LBBS is different from that of laparoscopic adjustable gastric band. LBBS uses a prosthesis to induce weight loss and may be associated with inherent complications that include food intolerance, ring/band migration, ring slippage, and adhesions to prosthesis or/and hypertrophic reactions to prothesis that cause outlet stenosis and obstruction. Food intolerance is mostly treated by nutritional counseling. Band migration is mostly treated by endoscopic intervention. Laparoscopic intervention is rarely indicated in centers with experienced endoscopic interventionist. The benefit of weight loss maintenance from the implanted prosthesis outweighs the risks of complications. However, long-term follow-up data with comparative study is awaited.