Superobesity and LapBand

8 Years Experience

Superobesity

Index of Quetelet (Body Mass Index)

B.M.I. = Weight / Height2

16,8 % of all patients with Lap Band

MiddleMiddle Age Age ------------------------------ 38,8 38,8 YearsYears

minmin. . -------------------------------------------- 18 18 yearsyears

maxmax. . ------------------------------------------ 66 66 yearsyears

Female – 78,8%

Male -21,2%

Middle Weight 153,4 Kg

minimal 116 Kg

maximum 263 Kg

Median Body Mass Index (BMI)

56,7 Kg/m2

minimal 50,1 Kg/m2

maximum 77,3 Kg/m2

COMORBIDITIESCOMORBIDITIES

160 PATIENTS 160 PATIENTS –– (80%)(80%)

••OSTEOARTROPHATY(jointOSTEOARTROPHATY(joint painpain) ) ------------------ 57%57%

••Arterial Arterial HypertensionHypertension ------------------------------------------ 32%32%

••Diabetes Diabetes mellitusmellitus typetype 2 2 -------------------------------- 43,7%43,7%

••RoncophatyRoncophaty ---------------------------------------------------------------- 32%32%

••SleepSleep ApneaApnea SyndromeSyndrome ------------------------------------ 16%16%

••HypotirodismHypotirodism -------------------------------------------------------- 0,8%0,8%

••HiatalHiatal HerniaHernia ---------------------------------------------------------- 6%6%

••GRD + GRD + HiatalHiatal HerniaHernia ------------------------------------------ 2%2%

••CholelitiaseCholelitiase ____------------------------------------------------------ 10%10%

Middle time of surgery --- 65 mns

min. 40 mns – max. 190 mns

Median time of Hospital Stay2 days

min. 1 day --- max. 16 days

PostPost operativeoperative MorbidityMorbidity

��2 2 portport infectionsinfections ------------ replacementreplacement

��1 1 bandband infectioninfection ---------------------- removalremoval

��PneumonyaPneumonya ------------------------ 2 2 patientspatients

��DisphagiaDisphagia -------------------------------- 3 3 patientspatients

��T E P T E P ------------------------------------------ 1 1 patientpatient

Complications with LapBand

5.0%5.1%10.121TOTAL

1.5%1.53Port infection

3.6%3.67Break/desc port-tube

1.5%1.53Band rupture

0.5%0.51Band infection

1.5%1.53Slippage

1.5%1.53Pouch dilatation

Maj. SurMin.Sur%Nº pat.

Kind

REINTERVENTIONSREINTERVENTIONS

� 11 major- 5,55%

3 - replacements

6 – band reposition

1 – Conversion to Scopinaro

1 – Conversion to sleeve gastrectomy

� 10 minor – 5%

Replacement of port ----------- 4

reconnection tub / port -------- 6

Follow-up

� 3 months-- 196/198

� 6 months-- 196/198

� 9 months-- 174/178

� 12 months- 156/160

� 18 months- 131/137

� 24 months- 112/119

� 36 months---- 82/88

� 48 months---- 47/52

� 60 months---- 26/29

� 72 months---- 20/20

� 84 months---- 20/20

� 96 months ---- 4/4

96,4%

Evolution of Weight, BMI and % EWL on superobese patients

0

20

40

60

80

100

120

140

160

0 3 6 9 12 18 24 36 48 60 72 84 96

Weight

BMI

%EWL

Evolution of Comorbidities

Comorbidities Nºpatients

Withoutdisease

Improved Unchanged

Osteoartrophaty 91 45 39

Roncophaty 51 32 18

Arterial Hypertension 51 28 15 8

Sleep Apnea Sind. 26 13 10

Type 2 Diabetes 70 48 16 6

3

1

7

CONCLUSION

� Our results show that Lap Band is a

very good surgical treatment for

superobese patients, without great

complications and with a very good

result on weight lost and resolution

of the comorbid diseases