Reoperations were common in all groups .
Reoperation rate was initially high but reduced markedly with improved b and and surgical and aftercare techniques .
Conclusion All current procedures are associated with substantial and durable weight loss .
More long-term data are needed for one-anastomosis gastric bypass and sleeve gastrectomy  .
Reoperation is likely to remain common across all procedures
Introduction Durability is a key requirement for the broad acceptance of bariatric surgery .
10-year Follow-up of Laparoscopic Vertical Banded Gastroplasty: Good Results in Selected Patients
Objective : To evaluate the long-term results of laparoscopic vertical b and ed gastroplasty ( VBG )  for morbid obesity . Background : Laparoscopic VBG , a safe and straightforward bariatric procedure characterized by good short-term results , has been progressively replaced by other more complex procedures on the basis of a presumed high rate of long-term failure . Nevertheless , some authors have recently reported long-term efficacy in selected patients . Methods : All patients who underwent laparoscopic VBG  were included in a prospect i ve data base . Patients reaching 10-year follow-up received a complete evaluation including clinical , endoscopic , and biochemical examinations . Results : Between January 1996 and March 1999 , 266 morbidly obese patients underwent bariatric procedures . Among them , 213 were selected for laparoscopic VBG ; exclusion criteria were as follows : contraindications to pneumoperitoneum , gastroesophageal reflux disease , and psychological contraindications to restrictive procedures . Mean age , preoperative weight , and body mass index were 36.9 years , 123.6 kg , and 45.4 kg/m2 , respectively .  Intraoperative complication rate and conversion rate were 0.9 % and 0.9 % , respectively . Early postoperative complication rate was 4.2 % and early reoperation rate was 0.5 % . Mean hospital length of stay was 6.3 days . Mortality was nil . The 10-year follow-up rate was 70.4 % ( 150 patients ) . Late postoperative complication rate was 14.7 % , and 10-year revisional surgery rate was 10.0 % . The excess weight loss percentages at 3 , 5 , and 10 years were 65.0 % , 59.9 % , and 59.8 % , respectively . The resolution and /or improvement rate for comorbidity were 47.5 % for hypertension , 55.6 % for diabetes , 75 % for sleep apnea , and 47.4 % for arthritis . Mean Moorehead-Ardelt Quality of Life Question naire and BAROS values were 1.4 and 3.8 , respectively . Conclusions : The present study demonstrates that laparoscopic VBG in carefully selected patients leads to long-term results comparable with more complex and invasive procedures . Given the low postoperative morbidity for laparoscopic VBG , its present clinical role should be , in our opinion , reevaluated
Reoperations were common in all groups .
Reoperation rate was initially high but reduced markedly with improved b and and surgical and aftercare techniques .
Conclusion All current procedures are associated with substantial and durable weight loss .
More long-term data are needed for one-anastomosis gastric bypass and sleeve gastrectomy  .
Reoperation is likely to remain common across all procedures
Introduction Durability is a key requirement for the broad acceptance of bariatric surgery .