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Research Letter |

Revisional Surgery After Laparoscopic Adjustable Gastric Banding in a National Australian Cohort

Catherine L. Keating, MPH1; Jaithri Ananthapavan, MPH1
[+] Author Affiliations
1Deakin Health Economics, Deakin University, Melbourne Burwood Campus, Burwood, Victoria, Australia
JAMA Surg. 2014;149(8):874-875. doi:10.1001/jamasurg.2014.93.
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A recent systematic review reported wide-ranging long-term revision or reversal rates after laparoscopic adjustable gastric banding (LAGB) of between 8% and 60%.1 The marked variability is likely due to different definitions of revisional surgery, different follow-up durations, and the different “eras” of the surgical cohorts. The studies reviewed provided little detail regarding the types of revisional procedures performed.1 Two recent studies1,2 have significantly advanced evidence in this area. The Longitudinal Assessment of Bariatric Surgery2 in the United States reported that of 610 patients undergoing LAGB, the rate of revisional surgery was 17.5 events per 100 patients over 3 years, primarily for band removal, revision to another bariatric procedure, or port revision. O’Brien et al1 reported that of 1370 patients undergoing LAGB at an Australian bariatric center, the rate of revisional surgery was 15.3 events per 100 patients over 3 years, primarily for repositioning of the gastric band or port revisions. The present study reports revisional surgery rates for the national population of Australians undergoing LAGB between July 1, 2005, and June 30, 2006.

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Figure.
Age and Sex Distribution of the Annual Cohort of Patients Receiving Gastric Banding in 2005-2006 (N = 6037)

The source for the data is Medicare Australia. Identification was based on utilization of Medicare Benefits Schedule item 30511 (gastric reduction or gastroplasty for morbid obesity, by any method), which is primarily used for laparoscopic adjustable gastric banding in Australia.3

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