New adjustable gastric bands available in the United States: a comparative study

Background: New gastric bands have been available for the past 3 years in the United States: Lap-Band AP (LBAP), Realize Band (RB), and Realize Band C (RBC). No RBC data have been previously published. The objective of the present study was to report our experience with 3 newer gastric bands in an experienced, private, U.S. bariatric surgery center.

Methods: Data were prospectively collected and retrospectively reviewed. The characteristics evaluated include age, body mass index (BMI), gender, percentage of excess weight loss, band fill volumes, and complications.

Results: From April 2007 through February 2010, 633 patients (mean age 42.3 ± 10.3 years) underwent laparoscopic band placement. The LBAP was placed in 384 patients (78% women, BMI 45.4 ± 6.9 kg/m(2)), the RB in 167 patients (84% women, BMI 46.4 ± 7.9), and the RBC in 82 patients (76% women, BMI 46.1 ± 8.2). The corresponding mean 1-year percentage of excess weight loss was 44.4% ± 19%, 38.9% ± 16.2%, and 32.1% ± 16.1% (LBAP versus RB and RBC, P <.05), with a 91%, 90%, and 83% follow-up rate. The 2-year percentage of excess weight loss for the LBAP and RB patients was 52.5 ± 21.2 and 43.3 ± 21.3 (P <.05), respectively, with a 76% and 67% follow-up rate. The corresponding mean band volumes at 1 year were 4.6, 7.6, and 10.2 mL, with 2%, 12%, and 38% of the bands filled more than the manufacturer's maximal volume capacity recommendation. The postoperative complications included slippages and erosions in .5% and .5% of the LBAP, .6% and 1.8% of the RB, and 1.2% and 0% of the RBC patients, respectively.

Conclusion: Of the new bands available in the United States, the LBAP provided significantly better weight loss in our private practice setting. The RBC patients had the least weight loss, with a high band-fill volume needed to achieve effective restriction.