In response to a previous post about Gastric Bypass not done around the world. I am aware that Lap-Band (or other adjustable gastric bands -- there are 2 or 3 other options in Europe) make up 80% of the weight loss surgeries performed in Europe and Australia, where the Lap-Band has been performed since 1991. In the US, where the Lap-Band was only FDA approved in 6/1991, there were only about 15-20,000 Lap-Bands performed in the last year, where there were about 200,000 weight loss total surgeries performed. So about 10% of surgery in the US is the band and most of the rest is the bypass. I expect the Lap-Band to make up a larger and larger percentage of weight loss surgeries, probably to approach 50-80% in the next few years. A recent announcement by Medicare said that they will start covering the band in all ages in addition to covering the bypass which they have covered for a long time. Many of the medicare patients that I saw ended up getting a bypass even though a band was their 1st choice. I believe both the Band and the bypass are safe and effective procedures, with definite differences, I leave the choice of type of surgery up to the individual patient.
I have seen much less than that 25% failure rate, and the patients that do the worst are the least compliant. Still, the band is meant to be there forever and over a long period of time, compliance can be taught. I have removed two bands, out of about 250 and I feel those two patients could have done better with band if they worked with the band longer, but there were other circumstances that led to band removal. In one, I converted to RYGB.
David Geller, MD