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 .
Long-term results after laparoscopic adjustable gastric banding: a mean fourteen year follow-up study.
BACKGROUND For over a decade , the laparoscopic adjustable gastric b and ( LAGB ) was 1 of the most performed bariatric procedures in Europe . This study is a retrospective analysis with prospect ively collected data of the experience in 1 specialized Dutch center with the adjustable gastric b and over 14 years . METHODS Between 1995 and 2003 , 201 patients underwent an LAGB for morbid obesity in our hospital . Data on preoperative clinical characteristic , postoperative outcome and weight loss patterns , and co-morbidities for up to 18 years are presented and evaluated using the Bariatric Analysis and Reporting Outcome System ( BAROS ) . RESULTS Average follow-up was 13.6 ( ± 2.0 ) years ( 163 mo ) and 99 % of patients with complete follow-up . Two thirds of patients reached an excess weight loss (EWL)>50 % at some point after LAGB placement . However , due to insufficient weight loss or complications in 53 % of patients , the LAGB had to be removed or converted to a Roux-en-Y gastric bypass . Additionally , half of the remaining patients had disappointing results according to the BAROS score . In total , less than one quarter ( 22 % ) of patients had a functioning b and with a good result after the follow-up period . Although initially the number of patients experiencing co-morbidities was reduced , most of them returned and a large number of patients developed new co-morbidities . Complications , other than weight regain , were numerous as 47 % of patients experienced at least 1 . In total , 204 reoperations were performed in 137 ( 68 % ) patients . Furthermore , patients who were lost to follow-up did almost twice as bad in terms of EWL compared to patients who had regular follow-up . CONCLUSION Morbid obesity is a chronic disease that can be resolved with bariatric surgery . One of the treatment options is the LAGB , which in the short term shows good results in terms of EWL and co-morbidity reduction . In the long term , however , EWL and co-morbidity reduction are disappointing , and the LAGB does not seem to live up to expectations . Besides the decrease in EWL over time , the number of reoperations required is alarming . In total , less than a quarter of patients still had a functioning b and after a mean 14 years of follow-up
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 .