Authors' objectives:

This report is a systematic review of the literature on laparoscopic adjustable gastric banding (LAGB) for morbid obesity. Two questions were developed and are covered in this report:

- What is the value of LAGB in the treatment of morbidly obese patients (BMI >= 35 kg/m2) who have failed to lose weight through non-surgical means compared with vertical banded gastroplasty (VBG)?

- What is the value of LAGB in the treatment of morbidly obese patients (BMI >=35 kg/m2) who have failed to lose weight through non-surgical means comparedwith open Roux-en-Y gastric bypass (RYGB)?

Authors' results and conclusions: Conclusions pertaining to the effectiveness of LAGB are based upon level III and level IV evidence. No randomised trials of LAGB against open RYGB or VBG were identified. LAGB is less efficacious than RYGB in terms of weight loss. There is some evidence that RYGB patients may be happier with their procedure than LAGB patients. Length of hospital stay and length of procedure appear to be lower in LAGB patients. On the basis of the available evidence it appears that LAGB is as efficacious as VBG in terms of weight loss. There is some preliminary evidence that weight loss is maintained longer in patients undergoing LAGB than in patients undergoing VBG. There do not appear to be any significant differences between quality of life measures, length of procedure, or length of hospital stay in patients with VBG or LAGB. There is no evidence that any of the three procedures are significantly better at resolving obesity related co-morbidities than any of the other procedures. Follow-up information on a very limited number of patients included in level IV reports indicates that weight loss may be maintained up to seven years after an LAGB procedure.

Authors' recommendations: MSAC recommended that on the strength of evidence pertaining to safety, effectivenessand cost-effectiveness of laparoscopic adjustable gastric banding, public funding should be continued for this procedure.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.msac.gov.au/reports.htm

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Medical Services Advisory Committee

Contact Address: MSAC (MDP 107), GPO Box 9848, Canberra, ACT 2601, Australia. Tel: +61 2 6289 6811; Fax: +61 2 6289 8799.

Contact Name: msac.secretariat@health.gov.au

Contact Email: msac.secretariat@health.gov.au

Copyright: Medical Services Advisory Committee (MSAC)