The Bariatric Examiner
September, 2010
In this issue...
(click the following links to jump down the page to each section, or use the scrollbar on the right to review all news and research updates)
- Bariatric surgery procedure updates
- 3 types of adjustable gastric banding systems: Which is best?
- General News & Research
- Updated Contraceptive Guidance Issued for Bariatric Surgery Patients in the U.S.
Bariatric Surgery Procedure Updates
Enjoy this newsletter?
If so, please pay it forward by referring the free sign up page to a friend or colleague.
Click here to do so now!
(we promise only to use their email address(es) to send the a link to the sign-up page)
If you haven't subscribed yet, click here to sign up for free.
3 types of adjustable gastric banding systems: Which is best?
There are currently three adjustable gastric bands available: the Lap Band AP, the Realize Band and the Realize Band C.
In an effort to determine whether one was more effective than the others – both in terms of weight loss and complications – a private bariatric surgery practice evaluated 633 patients over a period of 2 years 10 months. This has been one of the first studies to evaluate the Realize Band C.
Following were their results:
| Lap Band AP | Realize Band | Realize Band C | |
|---|---|---|---|
| % Excess Weight Loss – 1 Year | 44.4% | 38.9% | 32.1% |
| % Excess Weight Loss – 2 Years | 52.5% | 43.3% | n/a |
| Mean Band Volumes – 1 Year | 4.6cc | 7.6cc | 10.2cc |
| % of bands filled over the manufacturers’ maximum volume capacity recommendations | 2% | 12% | 38% |
| Postoperative band slippage | 0.5% | 0.6% | 1.2% |
| Postoperative lap band erosion | 0.5% | 1.8% | 0% |
The researchers concluded that their Lap Band AP patients experienced significantly better weight loss and the least band fill volume needed to “achieve effective restriction”.
For the complete study abstract, click here.
Other studies comparing the Lap Band to the Realize Band (formerly called the Swedish Adjustable Gastric Band) have showed a slightly lower discrepancy.
Our Gastric Lap Band Procedure page reviews the differences between the Lap Band and Realize Band along with additional study results comparing the two.
General News & Research
Updated Contraceptive Guidance Issued for Bariatric Surgery Patients in the U.S.
The Centers for Disease Control (CDC) in conjunction with the World Health Organization (WHO) have finalized their 2010 recommendations for female contraceptive use, including contraception for bariatric patients.
Their recommendations for female bariatric patients, which are meant to guide patients’ discussions with their doctors and are based on safety (rather than effectiveness, availability or acceptability), include:
| Restrictive Procedures* | Malabsorptive Procedures* | CDC Comments | ||
|---|---|---|---|---|
| *Restrictive procedures include: vertical banded gastroplasty, laparoscopic adjustable gastric band, laparoscopic sleeve gastrectomy Malabsorptive procedures include: Roux-en-Y gastric bypass, biliopancreatic diversion, duodenal switch The CDC report also indicates that bariatric surgical procedures involving a malabsorptive component have the potential to decrease oral contraceptive effectiveness, perhaps further decreased by postoperative complications such as long-term diarrhea and/or vomiting. |
||||
| Barrier methods | No restrictions | No restrictions | n/a | |
| Combined hormonal contraceptive patch | No restrictions | No restrictions | n/a | |
| Combined hormonal vaginal ring | No restrictions | No restrictions | n/a | |
| Combined oral contraceptive | No restrictions | Risks outweigh the advantages of using this method | See footnote regarding malabsorptive procedures. | |
| Copper intrauterine device | No restrictions | No restrictions | n/a | |
| Depot medroxyprogesterone acetate | No restrictions | No restrictions | n/a | |
| Emergency contraceptive pills | No restrictions | No restrictions | See footnote regarding malabsorptive procedures - for these procedures, an emergency intrauterine device might be more appropriate than emergency contraceptive pills. |
|
| Implants | No restrictions | No restrictions | n/a | |
| Levonorgestrel-releasing intrauterine device | No restrictions | No restrictions | n/a | |
| Progestin-only pill | No restrictions | Risks outweigh the advantages of using this method | n/a | |
The report also lists bariatric surgery as one of the conditions that “exposes a woman to increased risk as a result of unintended pregnancy”.
See our Pregnancy After Weight Loss Surgery page for more information about infertility, contraception and pregnancy before and after bariatric surgery.
Enjoy this issue?
If you haven't subscribed yet, click here to sign up for free.
If you've already signed up, please pay it forward...
For additional research, search for your topic...
Also see...
- The Bariatric Surgery Blog - snippets of information keep you even more informed
In the spirit of full disclosure: We proudly support this website through advertising and affiliate ("aff") marketing. In other words, when you click on a link that takes you outside of this website, we sometimes earn a small commission. These small commissions allow us to keep the site up and running and to continue offering it completely free of charge to you. Rest assured that all content, recommendations and advice are created before, and are independent of, any sponsorship or affiliate relationship. Click here for more info.
New! Comments
Have your say about what you just read! Leave a comment in the box below.