Background

The LAGB is one of the three most common bariatric surgical procedures performed in the United States. The procedure’s effectiveness and reversibility make it an attractive treatment option for obesity but concerns regarding its safety have limited its use. Our aim was to report the rates of readmissions and reoperations with LAGB.

Methods

We performed a retrospective analysis of a quality improvement database of patients undergoing LAGB from March 2012-December 2016. Patients’ baseline demographical data, readmission and reoperation rates stratified in 3 BMI ranges (30-35.99, 36-39.99 and >40) over four years was performed.

Results

A total of 5263 patients’ data across four different sites was analyzed. Average age and BMI were 43.5 ± 12.1 years and 40.83 kg/m2, respectively. Readmission rates at 1, 2, 3, and 4 years were 0.9%(n=47),0.9%(n=48), 0.5%(n=26) and 0.3%(n=14), respectively. The proportion of re admissions due to band slippage at year 1 for BMI ranges 30-35.99, 36-40 and >40 were 23.1%, 53.3% and 12.8%, respectively. At year 2, band slippage represented 11%, 25% and 27.5% of the readmissions for each respective BMI group. Third year band slippages represented 25%, 25% and 8.7% of readmissions. At year 4, only 11% of the readmissions were due to band slippages in the BMI >40 group. The overall rate of reoperations at years 1, 2, 3 and 4 were 2.6% (n=139), 2% (n=109), 1.1% (n=57), and 0.4% (n=20). Band removal comprised 16%, 19.2% and 16.7% of the reoperations at year 1 for each respective BMI group, and band/port issues comprising 36%, 26.9% and 31.9% of the reoperations. Year two band/port issues comprised 50%, 52% and 41.7% of the reoperations for each BMI group, followed by band removal rates of 25%, 28% and 25%. At year three band removal reoperations represented 40%, 33.3% and 33.3% in each BMI group, followed by 40%, 55.6% and 36.4% for band/port issues. 100% of the reoperations were for band removal in the BMI 30-35.99 group, followed by 66.7% and 40% in the BMI 36-40 and >40 groups, respectively. Port/Band issues represented 33.3% and 20% of the re-operations in the BMI 36-40 and >40 groups. (Table 1)

Conclusions

Rates of hospital readmission and reoperations in this database were lower than other published reports. Band slippage and port/tubing issues represented the majority of readmissions with port/tubing revisions and band removal most common reoperations. The LAGB may be safer than previously described.