The Story of Weight Loss Surgery

Gastric Bypass History and Development

Weight loss surgery was introduced in the United States in the 1960s. The gastric bypass was based on the weight loss observed among patients undergoing partial stomach removal for ulcers. Over several decades, the gastric bypass has been modified into its current form, using a Roux-en-Y limb of intestine (RYGBP).  Because the bypassed portion of intestine is where the majority of calcium and iron absorption takes place, anemia and osteoporosis are the most common long-term complications of the RYGBP. Therefore, lifelong mineral supplementation is mandatory. Other clinically important deficiencies that may occur include deficiencies of Vitamin B 1 (thiamine) and Vitamin B 12. Lifelong follow-up with a bariatric program and daily multi-vitamins are strongly recommended prevent nutritional complications. Although we are seeing a rapid increase in people selecting to have LAGB surgery, Gastric Bypass surgery remains the most common form of weight loss surgery performed in the United States today.

Development of the Laparoscopic Adjustable Gastric Band

The first concept for the gastric band was developed in 1985 by Professor Dag Hallberg, incooperation with a Swedish medical equipment company. Soon thereafter, Dr. Lubomir Zukmakpioneered the technology in the United States. Clinical trials in select United States centersbegan in June 1995. The LAP-BAND® System was approved by the FDA in June 2001 for usein weight reduction for severely obese adults with a Body Mass Index (BMI) of 40 or more, or foradults with a BMI of at least 35 plus at least one severe obesity-related health condition, suchas Type 2 diabetes, hypertension and asthma.The name “LAP-BAND” originated from the surgical technique used, laparoscopic, and thename of the implanted medical device, gastric band. The LAP-BAND® System is a silicone ringdesigned to be placed around the top portion of the patient’s stomach, creating a small gastricpouch and stoma. The inner surface of the band is inflated with sterile saline to create theproper stoma diameter and pouch size. By reducing stomach capacity, the LAP-BAND® Systemmay help achieve long-term weight loss in severely obese adults by creating an earlier feeling ofsatiety thus limiting or reducing food consumption. The LAP-BAND® System is adjustable,which means that the inflatable band can be tightened or loosened to help the patient achieve alevel of satiety while maintaining a healthy diet.*Advantages of the LAP-BAND® System include:• Less invasive bariatric surgical option*i,ii,iii• Fewer Risks and Side Effects*iii• Adjustable• Reversible• Effective Long-Term Weight Lossiv* As compared with gastric bypass  

HISTORICAL TIMELINE

1985    Professor Dag Hallberg, in cooperation with a Swedish medical equipment company,developed the first concept for the gastric band. His work was followed by Dr.Lubomir Kuzmak, who pioneered the technology in the United States.

1986    June marked the first use of open adjustable silicone gastric banding (ASGB).

1990    In April, ASGB was used for the first time in Europe. In December, the first FDAapprovedASGB clinical trial started in the United States and the first ASGBworkshop was held in Europe.

1993    The first laparoscopic banding procedure was performed in Belgium.

1994    U.S. based medical device company, Inamed Corporation, created the first workshopfor the LAP-BAND® System in Europe.

1995    The FDA approved the Investigational Device Exemption (IDE) for a clinical study ofthe LAP-BAND® System in the United States.

2001    The LAP-BAND® System received FDA approval for commercial distribution.

2007    To date, the LAP-BAND® System has been implanted in over 300,000 proceduresworldwide.

© 2007   Allergan, Inc. Irvine, CA 92612. ® and ™ marks owned by Allergan, Inc

.i Chapman A, Game P, O’Brien P, Maddern G, Kiroff G, Foster B, Ham J. Executive summary: Laparoscopic adjustable gastric banding for thetreatment of obesity: Update and re-appraisal. Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S) ReportNo. 31, Second Edition. Adelaide, South Australia: ASERNIP-S, June 2002. (Laparoscopic adjustable gastric banding surgery, like the LAP-BAND®surgery, is associated with a mean short-term mortality rate of around 0.05% compared to 0.50% for Gastric Bypass and 0.31% for Vertical BandedGastroplasty.)ii Parikh MS, Shen R, Weiner M, Siegel N, Ren CJ. Laparoscopic bariatric surgery in super-obese patients (BMI>50) is safe and effective: a review of332 patients. Obes Surg. 2005 Jun-Jul;15(6):858-63.iii Chapman AE, Kiroff G, Game P, Foster B, O'Brien P, Ham J, Maddern GJ. Laparoscopic adjustable gastric banding in the treatment of obesity: asystematic literature review. Surgery 2004;135:326-351.iv O’Brien P, Dixon J, LAP-BAND®: Outcomes and Results, J of Laparoend & Adv Surg Techniques, 13(4), 2003, 265-270.