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 .
Graft Survival and Complications after Laparoscopic Gastric Banding for Morbid Obesity—Lessons Learned from a 12-Year Experience
Laparoscopic adjustable gastric b and ing ( LAGB ) has been considered by many as the treatment of choice for morbid obesity because of its simplicity and encouraging early results . The aim of this prospect i ve study was to critically assess the effects , complications , and outcome after LAGB in the long-term , based on a 12-year experience . Between June 1998 and June 2009 , all patients with implantation of a LAGB  have been enrolled in a prospect i ve clinical trial . Results were recorded and classified , with special regard to long-term complications , re-operation rate , and graft survival .  LAGB was performed in 167 patients ( 120 female , 47 male ) with a mean age of 40.1 ± 5.2 years . Operative mortality was 0 % , overall 1.2 % ( not b and -related ) . Overall patient follow-up was 94.0 % . Mean excess weight loss ( EWL ) after 1 , 2 , 5 , 8 , and 10 years was 31.1 ± 7.5 % ( p < 0.005 ) , 44.2 ± 6.5 % ( p < 0.001 ) , 50.3 ± 6.9 % ( p < 0.001 ) , 51.7 ± 6.3 % ( p < 0.001 ) , and 48.8 ± 6.0 % ( p < 0.001 ) , respectively . The non-responder rate ( EWL < 30 % ) after 2 , 5 , 8 , and 10 years was 24.5 % , 18.3 % , 12.5 % , and 16.6 % , respectively . The early complication rate ( < 30 days ) was 7.8 % ( 13/167 ) , with 10 minor and three major complications . Late complications ( > 30 days ) occurred in 40.1 % ( 67/167 ) , of whom seven were minor and 60 were major complications ( three b and infections , two b and migrations , 11 b and leakages , two slippings/pouch dilatations , two b and intolerances , and 40 esophageal dilatations ) . The overall re-operation rate was 20.4 % ( 34/167 ) . The graft survival of the implanted b and after 2 , 5 , 8 , 10 , and 12 years was 98.8 % , 94.0 % , 86.8 % , 85.0 % , and 85.0 % , respectively . The failure rate of the procedure after 2 , 5 , 8 , and 10 years was 25.7 % , 24.3 % , 25.7 % , and 31.6 % , respectively . In the present long-term high-participation follow-up study ,  LAGB  is a safe and effective surgical treatment for morbid obesity . However , the high complication , re-operation , and long-term failure rates lead to the conclusion that LAGB should be performed in selected cases only , until reliable criteria for patients at low risk for long-term complications are developed
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 .