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Effects of Adjustable Gastric Bands on Gastric Emptying, Supra- and Infraband Transit and Satiety: A Randomized Double-Blind Crossover Trial Using a New Technique of Band Visualization

  • Physiology Research
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Abstract

Background

The laparoscopic adjustable gastric band (LAGB) has previously been classified as a restrictive procedure; physically limiting meal size. Recently, the key mechanism has been hypothesized to be the induction of satiety without restriction. Effects can be controlled by modifying LAGB volume, possibly as a result of effects on gastric emptying or transit through the LAGB.

Methods

Successful LAGB patients underwent paired, double blinded, esophageal transit and gastric emptying scintigraphic studies; with the LAGB at optimal volume and near empty. A new technique allowed assessment of emptying and transit through the infra- and supraband compartments.

Results

Fourteen of 17 patients completed both scans (six males; mean age, 48.9 ± 11.3 years, % excess weight loss 69.0 ± 15.2). At optimal volume a delay in transit of semi-solids into the infraband compartment was observed in ten patients vs. three when the LAGB was empty, (p = 0.01). The median retention of a meal in the supraband compartment immediately after cessation of intake was: empty 2.8% (2.3–7.9) vs. optimal 3.6% (1.7–4.5), (p = 0.57). Overall gastric emptying half time (minutes) was normal at both volumes: optimal 64.2 ± 29.8 vs. empty 95.2 ± 64.1, (p = 0.14). LAGB volume did not affect satiety before the scan: optimal 4.3 ± 1.9 vs. empty 4.0 ± 2.2, (p = 0.49), or 90 min later: optimal 6.1 ± 1.9 vs. empty 5.9 ± 1.4, (p = 0.68).

Conclusions

The optimally adjusted LAGB briefly delays semi-solid transit into the infraband stomach without physically restricting meal size. The supraband compartment is usually empty of an ingested meal 1–2 min after intake ceases and overall gastric emptying is not affected.

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Financial Support

The Centre for Obesity Research and Education has received financial support from Allergan Inc., the manufacturer of the LAP-BAND, in the form of an unrestricted research grant. Paul Burton has received research funding from the National Health and Medical Research Council and the Royal Australasian College of Surgeons.

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Authors and Affiliations

  1. Centre for Obesity Research and Education (CORE), Monash University, The Alfred Hospital, Commercial Rd Prahran 3181, Melbourne, Australia

    Paul Robert Burton, Wendy A. Brown, Cheryl Laurie & Paul E. O’Brien

  2. Department of Nuclear Medicine, The Alfred Hospital, Melbourne, Australia

    Kenneth Yap, Matthew O’Donnell & Victor Kalff

  3. Department of Gastroenterology and University of Melbourne, Royal Melbourne Hospital, Parkville, Australia

    Geoff Hebbard

Authors
  1. Paul Robert Burton
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  2. Kenneth Yap
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  3. Wendy A. Brown
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  4. Cheryl Laurie
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  5. Matthew O’Donnell
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  6. Geoff Hebbard
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  7. Victor Kalff
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  8. Paul E. O’Brien
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Correspondence to Paul Robert Burton.

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Burton, P.R., Yap, K., Brown, W.A. et al. Effects of Adjustable Gastric Bands on Gastric Emptying, Supra- and Infraband Transit and Satiety: A Randomized Double-Blind Crossover Trial Using a New Technique of Band Visualization. OBES SURG 20, 1690–1697 (2010). https://doi.org/10.1007/s11695-010-0278-9

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  • DOI: https://doi.org/10.1007/s11695-010-0278-9

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