Failure of the Band

Dear Dr. Rutledge,

You asked me about gastric banding in Germany.

Yes, it is still done in Germany.

For about 15 years (from about 1985 onwards) it was almost the only bariatric procedure in Germany (very popular in the late ninetees up to about 2007).

Since about 2007 patients interest in Gastric banding in Germany dropped dramatically.

Patients have come to know about the bad long term results of banding.

Most of the band patients either have been revised or at least would need to be revised at this moment for mid and long-term complications, insufficient weight-loss or serious weight regain.

I still do offer gastric banding for selected patients. This year I did ONE gastric banding among 80 bariatric operations in my small institution (and other collegues in Germany have made similar experiences).

On the other hand I took off bands or did Redo-surgery (mostly bypasses) on about 5 of my 80 patients.

Patients in Germany do refuse banding at these days and myself (as most of my German collegues) feel only few indications for GB (patients in high-risk situations who need little EWL, for instant renal failure patients who require access to a transplant list, young women with extremely high compliance and rather low BMI who seek for a procedure with minimal risk).

The sleeve-resection will probably go a similar way as gastric banding (my personal opinion).

I see more and more failed patients coming for ReDo after failed sleeve.

The only procedures with reliable long-term-results seem to be the different bypass-operations. Most of our patients do want a bypass, unfortunately too many (but less) want a sleeve gastrectomy (even if they could be operated with smaller risk at BMI < 50 with a bypass procedure).

MiniGastricBypass is a very promissing procedure which more and more of my patients actively are asking for. Patients are very well organised via internet and finally they decide more and more the choice of bariatric procedures in Germany.

Conclusion: Gastric banding in Germany has become a rather rare procedure !

Kind regards

Karl Rheinwalt

Dr. med. Karl Rheinwalt
Ltd. Arzt Department Adipositaschirurgie
und Metabolische Chirurgie
Ltd. Oberarzt Klinik für Allgemein-u. Viszeralchirurgie
St. Franziskus-Hospital
Schönsteinstr. 63
50825 Köln
Tel. 0221 – 5591 – 1050
Fax. 0221 – 5591 – 1049

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