• Weight loss: 50% EWL at 2 years
• Operative mortality: 0.1%
• Operative morbidity: 5%
• Long-term complications: gastric prolapse, stomal obstruction, esophageal and gastric pouch dilation, gastric erosion and necrosis, access port problems
  Buchwald, J Am Coll Surg 2005

Advantages

Disadvantages

• Simple to perform
• Lowest mortality
• Maintenance of GI tract continuity
• Same day procedure or overnight stay
• Lower incidence of short-term complications

• Foreign body complications: erosion, slippage, pouch dilation, esophageal dilation, dysmotility, dysphagia, access port complications
• High failure rate: 60-75%
• 24% reoperation by 5 years: Basso (Italy) 2008
• No alteration of metabolism
• Ineffective for super morbid obesity (BMI > 50)
• Higher incidence of long-term complications
• Need for a revision procedure which carries more risk than primary surgery

• A silicone band is placed around the upper part of the stomach
  • A small pouch is created
  • Stomach holds less food
  • Induces feeling of satiety
  • Shorter OR time
  • Evaluated every 6-8 weeks for gradual tightening if necessary