The guts of it

December 2009

FocusThe guts of it

Laparoscopic adjustable gastric banding - Effects, side effects and challenges

Volume 38, No.12, December 2009 Pages 972-976

Wendy Brown

Anna Korin

Paul Burton

Paul E O'Brien

Background

The laparoscopic adjustable gastric band is a useful tool in the treatment of severe obesity. It is a safe and durably effective procedure, however, optimal results depend upon the patient participating in a process of lifelong care.

Objective/s

This article discusses the procedure, follow up, and late complications for laparoscopic adjustable gastric banding. It also provides the general practitioner with ‘alert’ symptoms and signs of when to contact the treating surgeon.

Discussion

Lifelong care involves counselling about food choices and eating patterns, as well as adjustment of the device. The delivery of this care usually involves a multidisciplinary team. Patients should not be offered surgery unless a process for continuing care is in place. Late complications of laparoscopic adjustable gastric banding are relatively common; however, they can be readily treated in most cases, with weight loss continuing. Symptoms of volume reflux, nocturnal aspiration, dysphagia, regular regurgitation and vomiting may alert the primary care GP to complications. Abdominal pain along with any of these symptoms may suggest an acute complication, but other causes of abdominal pain should also be considered, depending on the clinical scenario.

Obesity is a common and significant health problem in Australia. In 2008, an estimated 3.71 million (17.5%) Australians were obese – 1.76 million (16.5%) males and 1.95 million (18.5%) females.1 These estimates were 14.5% higher than 2005 estimates.

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Correspondence afp@racgp.org.au

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