"Longterm results for LapBand weight loss surgery https are relatively poor according to a new study from Belgium. But a spokesman for the company that manufactures LapBand says the study is flawed. Nearly half of the  patients followed for  years or longer required removal of the bands and about  had major complications the researchers found. The average weight https loss was below what experts consider good results. Even so a majority of the patients in their small study said they were satisfied with the procedure. Despite that degree of satisfaction I think people have exaggerated expectations from the band procedure says researcher Jacques Himpens MD an attending surgeon at St. Pierre University Hospital in Brussels. His study findings he tells WebMD are a reality call. But some including the manufacturer of the LapBand  used in a technique called laparoscopic adjustable gastric banding https  take exception to the study criticizing the small sample size and the number of patients lost to followup. The critics also point out that both the device itself and the expertise of surgeons placing it have improved greatly since the patients in the study had their bands placed in the years  through . But Himpens tells WebMD hes skeptical either would make much difference. My impression is even with the newer band the results are not significantly better he says. He emphasizes he is not against the use of gastric band surgery but that based on his study results patients who opt for the procedure should know theres a good chance they will need a followup procedure and they may have less weight loss https and more complications than those who choose other weight loss surgeries. Weight Loss Surgery In  about  obese https people had bariatric surgery https according to the American Society for Metabolic  Bariatric Surgery https choosing from the gastric banding https technique gastric bypass surgery https and other procedures. Gastric banding https involves creating a small pouch by wrapping a silicone band around the upper part of the stomach https thus making a patient feel full after eating less. The Belgian research published in the Archives of Surgery is thought to be the first study that follows gastric banding patients for more than  years. Himpens and his colleagues set out to follow  patients who had the procedure from  to . They wanted to assess a number of outcomes including death rate complications both minor and major amount of weight loss number of corrective operations effect on other problems such as high blood pressure https and patient satisfaction. The median age of the patients was  half were older half were younger. Many patients were lost to followup with just . or  having full data available. Among the findings  The death rate from the operation itself was zero although . of patients died during the study period from unrelated causes.   had major complications such as erosion of the band in which it erodes into the stomach and typically requires removal.  About  required band removal and nearly  needed additional procedures.  Average excess weight loss overall was . of excess weight after  years but  among those who still had their band at the end of followup. Greater than  is considered a good result experts say. Overall . of patients were satisfied.  About  of patients had type  diabetes httpsdiabetes.webmd.comguidediabetes_symptoms_types before band insertion while  had diabetes https  years after their procedure. Himpens reports consultant work for Ethicon Endosurgery which makes another gastric band Realize and for Covidien a health care https products company. Manufacturers Perspective In an email Cathy Taylor a spokeswoman for Allergan the maker of LapBand says While Allergan encourages and is committed to the ongoing publication of important balanced and robust scientific information to advance the practice of medicine we are disappointed to see the publication of an illconstrued singlecenter clinical assessment that does not meet the high clinical standards one should expect from peerreviewed data and is not reflective of todays clinical standards. Among the flaws of the study she says are the incompleteness of patient followup. Bands have improved she says as have surgical techniques. The erosion rate is uniquely high she says strongly suggesting technical errors. She cites other research finding rates of . to . Other Views on Weight Loss Surgery The study results are a mix of good and bad news according to Bruce Wolfe MD president of the American Society for Metabolic  Bariatric Surgery and professor of surgery at Oregon Health  Science University in Portland. He reviewed the study for WebMD but was not involved in it. Some limitations are inherent he says such as the older bands used at the study start. There is some shorterterm data which indicates the complications Himpens reports as troublesome  mostly erosion  have been reduced with the improved band technique Wolfe tells WebMD. He reports consultant work in the past for Allergan. Even so he calls the finding of  with band erosion a concerning number. In a critique published along with the study Clifford W. Deveney MD a professor of surgery at Oregon Health  Science University who practices with Wolfe writes These data do not shed a favorable light on the use of laparoscopic adjustable gastric banding. Weight loss after banding he tells WebMD typically takes five years to achieve the maximum in his experience. With gastric bypass most of the loss is in the first one and a half years he says. That procedure involves reducing the stomach pouch size and typically involves bypassing part of the small intestine. Wolfe says the study should inspire those considering the gastric banding procedure to ask the doctor who is offering it about complication rates average weight loss and other outcomes."