This study compared outcomes of laparoscopic adjustable gastric banding (LAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in super morbidly obese patients (BMI > 50). LRYGB resulted in greater weight loss, reduction in comorbidities, fewer complications and reoperations compared to LAGB. LRYGB patients also reported better quality of life than LAGB patients. While LAGB had shorter operative time and hospital stay, it was associated with higher rates of late complications requiring reoperation. The study concludes that further evaluation is needed regarding the role of LAGB in super morbidly obese patients.

1. Laparoscopic Adjustable Gastric Band in Super Morbidly Obese Patients (BMI >50): A Prospective, Comparative Analysis Greece May 2005 Wilbur B. Bowne MD, Kell Julliard MS, Armando E. Castro MD, Palak Shah MD, Craig B. Morgenthal MD, Emad Kandil MD, Abel Gonzalez MD, Anthony J. Acinapura MD, George S. Ferzli MD, FACS

2. Laparoscopic Adjustable Gastric Band in Super Morbidly Obese Patients (BMI >50): A Prospective, Comparative Analysis Disclosure of Interest Declaration None Greece May 2005

6. Background: Incidence of complications and failure following LAGB YEAR # PATIENTS AUTHOR Suter et al. 2001 272 20 7 Biertho et al. 2003 805 74 9 Suter et al. 2000 150 24 16 Chevallier et al. 2004 378 91 24 Hol é czy et al. 2001 36 11 31 Gustavson et al. 2002 90 52 58 # FAILURES % Laparoscopic Adjustable Gastric Band in Super- Morbidly Obese

12. Morbid Obesity N = 315 patients Super-Morbid Obesity N = 106 Patients (34%) LAGB N = 60 Patients (57%) LRYGB N = 46 Patients (43%) Results: Surgical Pathway Laparoscopic Adjustable Gastric Band in Super- Morbidly Obese

25. Patient satisfaction Results: Quality of Life Laparoscopic Adjustable Gastric Band in Super- Morbidly Obese (N = 55) (N = 39)