The reporting of gastric band slip and related complications; a review of the literature.

Laparoscopic adjustable gastric banding is a safe and effective treatment for morbid obesity. Long-term complications include band slippage, gastric pouch dilatation and gastric erosion. Rates of band slippage reported in the literature range from less than 1% to over 20%. The aim of this review was to explore whether differences in the reporting of this complication contributed to the variability in this outcome measure. A full literature search was undertaken using EMBASE and MEDLINE search engines. Forty studies were selected for analysis based on inclusion and exclusion criteria. Each was scrutinised for outcome reporting methods and related fields. Accurate definitions for relevant terms were derived from the best available evidence. Considerable variations in device deployed, operative approach, band fixation technique, and outcome reporting mechanisms were seen between the studies. The explanation and definition of terms used within manuscripts were also seen to vary between studies. A consensus needs to be reached on how best to report complications such as gastric band slippage. We suggest which information should be included by authors to allow for accurate and reproducible reporting of such outcomes in the future.

The effects of laparoscopic adjustable gastric banding on idiopathic intracranial hypertension.

The purpose of this study was to determine whether laparoscopic adjustable gastric banding has a role in the treatment of idiopathic intracranial hypertension. This pilot study was undertaken in a single, tertiary referral centre. Data on all patients with idiopathic intracranial hypertension that have undergone laparoscopic adjustable gastric banding in our unit were collected from our prospectively maintained bariatric database. Additional information was obtained via telephone questionnaires and review of medical records. Four female patient with a mean age of 32 years (range 29-39 years) and mean pre-operative body mass index of 46.1 kg/m(2) (range 38.2-54.0 kg/m(2)) underwent laparoscopic adjustable gastric banding between June 2006 and July 2009. At a mean follow-up of 19.8 months all four patients reported either total resolution of headache or significant improvement in headache, with a mean improvement in pain score of 76.3/100 (range 55-95) on a analogue pain score. Mean excess weight loss at follow-up was 64.1% (range 50.1-88.2%). There were no complications or mortality in this cohort. This study suggests that laparoscopic adjustable gastric banding represents an effective and safe treatment for idiopathic intracranial hypertension associated with morbid obesity. We have shown good results both in terms of symptom resolution and weight loss, whilst avoiding alimentary tract diversion procedures in these young female patients. A randomized, controlled trial can be justified on the basis of this initial pilot study.