New research suggests that gastric bypass surgery may offer patients more weight loss than lap bands, but the procedure also appears to be more likely to cause complications, including death.
In a study published last week in the medical journal JAMA Surgery, researchers compared laparoscopic Roux-en Y surgery, more commonly known as gastric bypass, to laparoscopic adjustable gastric banding, or LAP-Band.
The weight loss surgeries are the two most common bariatric procedures, and the findings suggest that individuals who undergo gastric bypass surgery lost nearly twice the weight of patients who underwent gastric banding. However, gastric bypass surgery came with a higher risk of short-term complications and long-term hospitalizations.
The study used data from 10 health care systems in the United States, including nearly 7,500 people over the age of 21 who were studied from January 2005 to December 2009.
Gastric bypass makes the stomach smaller and reroutes the small intestine, so the body will not absorb all the calories from the food you eat. This is often used to address issues of extreme obesity and offers rapid weight loss.
Lap bands, or gastric banding, surgically places an adjustable band around the top of the stomach, creating a small stomach pouch that quickly fills with food. People undergoing this surgery tend to feel full after eating small amounts.
Three percent of patients who underwent gastric bypass experienced at least one or more complications following surgery. In some cases, those complications were severe, with 0.3% of patients suffering complications dying following surgery, 5.5% requiring another bariatric surgery later and 20% needing to be re-hospitalized. Comparatively, 1.3% of adjustable gastric banding patients experienced at least one or more major complications.
This group had a 0.2% death rate, 12% required re-hospitalization and 14% needed another bariatric surgery or other weight loss interventions.
Overall gastric bypass procedure patients had an average loss of 8 body mass index (BMI) points.
Gastric Banding Decreasing in Popularity
Researchers noted that lap banding surgery has dropped in popularity since the study began. At its peak, gastric banding represented 40% of bariatric procedures. Today lap banding represents less than 20% of surgeries.
More than likely, the rapid weight loss seen with other procedures is the driving factor. However, patients also face higher rates of extraction, with approximately five percent each year having the band removed.
Despite what the numbers indicate, experts report re-operation and intervention rates are much higher than indicated in the study.
Many patients will loss a significant amount of weight, but may also face long-term complications, including reduced survival rates, risks of microvascular and macrovascular events, negative mental health outcomes and increased costs, according to a study published last month.
Another study published in 2013, revealed may patients who underwent bariatric surgery experienced higher rates of complication if a surgeon with less experience conducted the surgery.