Adjustable silicone gastric banding vs vertical banded gastroplasty. Laparotomic and laparoscopic approach. Evaluation of complication[Bendaggio gastrico regolabile vs gastroplastica verticale: Approccio laparotomico e laparoscopico ed analisi delle complicanze]

Background. Aim of this study is to compare two different techniques of restrictive bariatric surgery: Adjustable Silicone Gastric Banding (ASGB) and Vertical Banded Gastroplasty (VBG) and to evaluate weight loss and complications. This is a retrospective analysis. Mean follow-up is 24 months; 13 Italian departments of surgery contributed to the study. All departments have a good experience in bariatric and/or advanced laparoscopic surgery. Methods. The number of patients studied is 2686: 1572 underwent ASGB (219 laparotomically and 1353 laparoscopically); 1114 underwent VBG (914 laparotomically and 200 laparoscopically). All selected patients are "morbid obeses"; BMI is between 40 and 50. ASGB is a silicone band with an internal inflating tube. It is fixed laparotomically or laparoscopically, around the stomach and below the cardia (2 cm). The band reduces food intake because of slow gastric emptying and is connected to a reservoir fixed under the anterior sheath of abdominal wall muscles to be calibrated. VBG (performed laparotomically or laparoscopically) consists of a cylindric pouch on the small curvature of the stomach performed by a suture mechanism (one circular and one linear with 4 rows of stitches). Results. The weight expressed in Body Mass Index (BMI), the percentage of excess weight loss (%EWL) and the early and intermediate postoperative complication have been evaluated. Conclusions. ASGB operation is easier to perform (laparoscopically too) than VBG but ASGB weight loss is less than VBG. ASGB complications are more frequent than VBG complications but treatment in ASGB cases is easier.