Paul E O'Brien
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.
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.
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
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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