Arizona LAP-BAND

Surgical Patients Also Benefit From a Reduction in Comorbidities Latest study in The Journal of the American Medical Association: The LAP-BAND helps reduce co-morbidities in diabetes. MELBOURNE, Australia, May 1 /PRNewswire/ -. LAP-BAND System surgery is significantly more effective in reducing weight and improving health and quality of life than non-surgical weight-loss programs, according to a study published in the May 2 issue of Annals of Internal Medicine. "This was one of the first rigorously controlled studies to measure the impact of weight-loss surgery against traditional weight-loss methods," said Professor Paul O'Brien, lead investigator and Director of the Centre for Obesity Research and Education at Monash University, where the study was conducted. "It confirms the results of prior studies that weight-loss surgery is superior over traditional approaches like diet and exercise alone." The study showed that LAP-BAND patients lost greater amounts of weight and saw a reduction in the metabolic syndrome, a condition in obese people where insulin levels are too high and which puts people at greater risk of problems such as type 2 diabetes, hypertension and abnormal blood lipid levels, than non-surgical patients-at no additional adverse risk. This randomized, controlled study directly compared LAP-BAND System surgery (the only FDA approved adjustable gastric banding procedure) to traditional, non-surgical weight-loss programs in mild to moderately obese patients. "Currently, the generally accepted practice is to perform weight-loss surgery only on the severely and morbidly obese," said Professor O'Brien. "But these positive results suggest that physicians should re-examine the guidelines for weight-loss surgery to determine if they should be expanded to include mild to moderately obese patients." The study was designed to assess whether surgical therapy for moderate obesity achieves better weight loss, health and quality of life than non-surgical therapies. At two-years, surgical patients had lost an average of 20.5 kg (45.1 lbs) or 21.6 percent of their average initial body weight. This weight loss was equal to 87.2 percent of the surgical group's excess body weight at the beginning of the study. The non-surgical group had lost an average of 5.3 kg (11.66 lbs) at two years, or 5.5 percent of their average initial body weight. This weight loss was equal to 21.6 percent of their excess weight at the beginning of the study. In addition to losing weight, the metabolic syndrome was significantly more likely to be resolved after two years in the surgical group than the non-surgical group. At the start of the study, metabolic syndrome was present in 38 percent of members of the surgical and non-surgical groups. At the end of the study, only 3 percent of laparoscopic adjustable gastric banding patients and 24 percent of non-surgical patients presented with metabolic syndrome. While both groups reported improvements in quality of life, participants who received the laparoscopic adjustable gastric band reported greater improvements. "With the LAP-BAND System, there is now a safer, less invasive and more acceptable surgical option for weight loss, and we have demonstrated that it is a powerful tool in reducing the dangerous and costly effects of the metabolic syndrome," said Professor O'Brien. Obesity is an important global health problem with a prevalence of more than 20 percent among the adult population in Western countries and more than 30 percent in the United States. It is estimated that there are more than 300 million obese people worldwide.(1,2) The increasing prevalence of obesity is associated with a parallel increase of numerous obesity-related diseases. Additional Study Results * The extent of weight loss was equal for both groups at 6 months, but then the non-surgical group regained weight that had been lost while surgical patients continued to lose and were continuing to lose through the study's conclusion. * The average surgical patient's body mass index (BMI) went from 33.7 at the beginning of the study to 26.4 after 2 years. The non-surgical group's BMI was reduced from an average of 33.5 at the beginning of the study to 31.5 at the study's conclusion. Study Methodology Investigators at Monash University's Centre for Obesity Research and Education randomized 80 mild to moderately obese adults (BMI of 30-35) to either a traditional, non-surgical medical weight-loss program or bariatric surgery. The non-surgical program was physician directed and consisted of behavioral modifications, a very low calorie diet and pharmacotherapy with orlistat plus education and professional support regarding appropriate eating and exercise behavior. The surgical group received the laparoscopic adjustable gastric band (LAP-BAND System, Inamed Health) procedure performed by standardized method by two experienced surgeons within one month of randomization. During the surgery, the surgeons inserted an inflatable band around the upper part of the patients' stomachs to create a small pouch limiting the amount of food consumption, which creates a feeling of fullness, resulting in weight loss. ABOUT MONASH UNIVERSITY Monash University is one of Australia's largest and most internationalized universities. It is highly regarded for its innovative approach to teaching and research. The university has more than 52,000 students from over 100 countries. It has six campuses in Australia as well as campuses in South Africa and Malaysia. It also has centers in London and in Prato in Italy. SOURCE Monash University

This is a great study done by a dedicated group of LAP-BAND groups out of Seattle. This was published in the prestigious Journal Obesity Surgery. This is a great study following a group of patients over one year. It showed that the LAP-BAND patients experienced a significant weight loss, resolution of co-morbidities, decreases in medication usage, and improvements in their quality of life. Laparoscopic Adjustable Gastric Banding: Weight Loss, Co-morbidities, Medication Usage and Quality of Life at One Year. Jessie H. Ahroni, PhD, ARNP; Kevin F. Montgomery, MD, FACS; Brad M.Watkins, MD, FACS. Obesity Surgery, 15, 641-647

Below is one of the larger case series of laparoscopic bands done in the United States, and reported in one of the premier medical journals. The study showed that rates of complications from the LAP-BAND are quite low. They reported rates of slippage (prolapse) of 1.4%, erosion into the stomach of 0.2%, tubing breaks 0.5%, Port problems 0.7%, obstruction of the stoma 0.8%, and band removal was 0.8%. There were no deaths in this very large series. This showed that dedicated centers, like our own, have far better results than centers not primarily dedicated to the LAP-BAND. Laparoscopic Adjustable Gastric Banding: 1,014 Consecutive Cases. Jaime Ponce, MD, FACS, Steven Paynter, MD, FACS, Richard From, MD, FACS. Journal of the American College of Surgeons, Vol 201 No. 4, October 2005.

This is a great paper out of Australia, from one of the premier LAP-BAND surgeon's, Paul O'Brien. This study showed that the gastric bands are semipermeable, leading to a small reduction in saline volume with time. It was recommended that patients attend for regular follow-up visits and seek help if the band's effectiveness appears reduced. Permeability of the Silicone Membrane in Laparoscopic Adjustable Gastric Bands has Important Clinical Implications. John Dixon, MBBS, PhD; Paul E. O'Brien, MD. Obesity Surgery; 15, 624-629

This is the largest study of gastric bypass patients ever reported. The study, published in October of 2005 shows that gastric bypass has a much higher morbidity and mortality among patients than most surgeons commonly report. This report, published in the prestigious Journal of the American Medical Association is rarely sighted by surgeons who perform the RNY gastric bypass. Note that the average age of the patient is 47.7 years, 75% were women. The one year mortality was 4.6%. These patients were carefully followed, and over 16,500 patients studied, reporting from a number of surgeons. Simply put, the risks of RNY-gastric bypass surgery is far higher than most surgeon series show. The LAP-BAND continues to be a safe procedure, with mortality statistics far lower than RNY- gastric bypass. D.R. Flum, L. Salem, JA Erod, E.P. Dellinger, A. Cheadle, L. Chan. Journal of the American Medical Association. October 19, 2005. ------------------------------- Our program is dedicated to the success of the LAP-BAND patient. Our great results come from our availability to patients and committment to provide educational programs as well as fills to our patients.

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