Adjustable Gastric Banding: Indications and Technique

Gastric banding for obesity treatment has evolved significantly since its inception in 1978 by Wilkinson and Peloso, who used nonadjustable bands. The development of adjustable gastric bands by Kuzmak and Foresell, initially placed via open surgery, was advanced with laparoscopic implantation by Broadbent and Catona in 1993. Today, only the Lap Band® is FDA-approved in the United States, with adjustable gastric banding accounting for about 1% of bariatric procedures nationwide. Complications such as band erosion and slippage prompted the development of the pars flaccida technique for laparoscopic band placement, which includes specific steps to minimize these issues. Success with adjustable gastric bands relies on proper patient selection, long-term follow-up, regular band adjustments, and comprehensive patient education. Detailed placement techniques and management strategies are covered in this chapter.