Laparoscopic Adjustable Gastric Banding (LAGB) Plus Anterior Fundoplication Versus LAGB Alone: A Prospective Comparative Study

Background: Laparoscopic adjustable gastric banding (LAGB) is a well-established and effective bariatric procedure, whose outcomes can be compromised by the slippage and the following removal of the band; the association between LAGB and gastric plication has recently been proved as a successful treatment for morbid obesity. The aim of this prospective randomized study was to compare weight loss and slippage rate between LAGB and LAGB plus anterior fundoplication. Methods: From January 2012 to May 2012, a total of 40 patients were allocated to undergo either LAGB (group A, n = 20) or LAGB plus anterior fundoplication (group B, n = 20). Data on the operative time, complications, hospital stay, total weight loss percentage (% TWL), percentage of excess weight loss (% EWL), and improvement of comorbidities were collected at 6, 12, and 36 months of follow-up. Results: All procedures were completed laparoscopically, and no significant difference of mean operative time was found between the 2 groups. The mean hospital stay was longer in group B than in group A (2.3 +/- 0.8 vs. 1.4 +/- 0.7 d, P < 0.005). Greater weight loss was found in group B rather than in group A at 6, 12, and 36 months. Obesity related comorbidities improved in both groups. Number of band regulations and slippage rate were lower in group B. Conclusions: Our experience shows that 36 months after surgery LAGB plus anterior fundoplication increases weight loss and reduces the slippage rate.