Background: At present, long-term results after conservative treatment of morbid obesity (body mass index > 40) are not satisfying, given a relapse rate > 95%. In comparison, surgical treatment is about 10 times more efficient and, thus, more cost-effective.
Surgical techniques: Currently performed surgical interventions to induce weight loss are dominated by two major surgical procedures: (1) Mason's vertical gastroplasty, and (2) the insertion of an adjustable gastric band, developed by Kuzmak in 1983. Essential advantages of gastric banding include the possibility of laparoscopic performance and complete reversibility of the operation. After removal of the gastric band, stomach and upper intestine are left in their anatomic and functional integrity.
Patients and results: During a 30-month period, we implanted the adjustable gastric band in 71 patients (65 female and six male patients). All procedures were performed laparoscopically. In none of the cases did intraoperative complications occur. Postoperatively 1.4% of the patients developed a slippage of the gastric band, 2.1% had complications concerning the subcutaneously placed port, and, eventually, the gastric band had to be removed in 1.4%.