Laparoscopic gastric banding for morbid obesity with expanded PTFE: technique and early results in the first 100 consecutive cases.

BACKGROUND/AIMS: Surgery is the only effective treatment for the truly morbidly obese patient. Gastric banding was demonstrated to be a safe, effective, and easily reversible technique in the open surgical approach. METHODOLOGY: A five-puncture technique, developed by the authors, for laparoscopic gastric banding utilizing an expanded polytetrafluoroethylene (ePTFE) band is fully described and discussed. This technique was utilized in 100 consecutive patients operated on between October 1995 and November 1996. RESULTS: We recorded no mortality, no cases of conversion, a 1% rate of major complications, a low minor morbidity rate (10%), and an acceptable length of operative time (106±8 minutes). This was significantly related to body weight, B.M.I. and % of I.B.W. being longer in more obese patients, but not to the experience of the surgical team. Weight loss (35.0±5.1kg), percentage of excess weight lost (55.3±5.3%), percentage of ideal body weight achieved (149.1±8.4%), and body mass index (33.8±2.0) were all significantly improved at 3, 6, 9 and 12-months follow-up. CONCLUSIONS: Early results of this series are promising, showing low morbidity and a rate of weight loss comparable to that achievable by means of open gastric banding or vertical banded gastroplasty. Any statement about long-term results deserves a longer follow-up.