Effects of gastric band adjustments on intraluminal pressure

Paul Robert Burton, Wendy Ann Brown, Cheryl Laurie, Melissa Richards, Geoffrey S Hebbard, Paul Edmond O'Brien

Research output: Contribution to journalArticleResearchpeer-review

26 Citations (Scopus)

Abstract

BACKGROUND: Understanding of the effects of adjustments to laparoscopic adjustable gastric band (LAGB) volume is limited. Changes in intraluminal pressure may be important and explain patients reporting a tighter LAGB after saline is removed and an identical volume replaced. METHODS: Using high-resolution manometry, changes in the basal intraluminal pressure at the level of the LAGB in response to sequential, small alterations in LAGB volume were recorded. All fluid was removed from the LAGB and replaced, pressures and motility were reassessed. RESULTS: Sixteen patients (four males, age 45.4 +/- 13.2 years) participated. A linear increase (r (2) = 0.87 +/- 0.12) in intraluminal pressure was observed after a threshold volume was reached. The threshold volume varied considerably (1.0 to 5.8 ml). The gradient of the linear increase was 21.2 +/- 8.7 mmHg/ml. The mean basal intraluminal pressure at the level of the LAGB was initially 19.1 +/- 8.9 mmHg and increased to 37.0 +/- 20.4 mmHg (p = 0.001) after removing and replacing the same volume of saline. There was an increase in distal esophageal peristaltic pressure (123.5 +/- 34.7 vs. 157.4 +/- 52.6 mmHg, p = 0.003) and a decrease in the proportion of normal swallows (0.85 +/- 0.22 vs. 0.53 +/- 0.47, p = 0.02). Nine patients also developed adverse symptoms. CONCLUSIONS: Intraluminal pressure at the level of the LAGB is an objective measure of the restriction produced by LAGBs. The addition of fluid to the LAGB results in a linear increase in intraluminal pressure once a threshold volume is reached. The removal and replacement of the same volume of saline from the LAGB may temporarily increase intraluminal pressure.
Original languageEnglish
Pages (from-to)1508 - 1514
Number of pages7
JournalObesity Surgery
Volume19
Issue number11
DOIs
Publication statusPublished - 2009

Cite this

Burton, Paul Robert ; Brown, Wendy Ann ; Laurie, Cheryl ; Richards, Melissa ; Hebbard, Geoffrey S ; O'Brien, Paul Edmond. / Effects of gastric band adjustments on intraluminal pressure. In: Obesity Surgery. 2009 ; Vol. 19, No. 11. pp. 1508 - 1514.
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abstract = "BACKGROUND: Understanding of the effects of adjustments to laparoscopic adjustable gastric band (LAGB) volume is limited. Changes in intraluminal pressure may be important and explain patients reporting a tighter LAGB after saline is removed and an identical volume replaced. METHODS: Using high-resolution manometry, changes in the basal intraluminal pressure at the level of the LAGB in response to sequential, small alterations in LAGB volume were recorded. All fluid was removed from the LAGB and replaced, pressures and motility were reassessed. RESULTS: Sixteen patients (four males, age 45.4 +/- 13.2 years) participated. A linear increase (r (2) = 0.87 +/- 0.12) in intraluminal pressure was observed after a threshold volume was reached. The threshold volume varied considerably (1.0 to 5.8 ml). The gradient of the linear increase was 21.2 +/- 8.7 mmHg/ml. The mean basal intraluminal pressure at the level of the LAGB was initially 19.1 +/- 8.9 mmHg and increased to 37.0 +/- 20.4 mmHg (p = 0.001) after removing and replacing the same volume of saline. There was an increase in distal esophageal peristaltic pressure (123.5 +/- 34.7 vs. 157.4 +/- 52.6 mmHg, p = 0.003) and a decrease in the proportion of normal swallows (0.85 +/- 0.22 vs. 0.53 +/- 0.47, p = 0.02). Nine patients also developed adverse symptoms. CONCLUSIONS: Intraluminal pressure at the level of the LAGB is an objective measure of the restriction produced by LAGBs. The addition of fluid to the LAGB results in a linear increase in intraluminal pressure once a threshold volume is reached. The removal and replacement of the same volume of saline from the LAGB may temporarily increase intraluminal pressure.",
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Effects of gastric band adjustments on intraluminal pressure. / Burton, Paul Robert; Brown, Wendy Ann; Laurie, Cheryl; Richards, Melissa; Hebbard, Geoffrey S; O'Brien, Paul Edmond.

In: Obesity Surgery, Vol. 19, No. 11, 2009, p. 1508 - 1514.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Effects of gastric band adjustments on intraluminal pressure

AU - Burton, Paul Robert

AU - Brown, Wendy Ann

AU - Laurie, Cheryl

AU - Richards, Melissa

AU - Hebbard, Geoffrey S

AU - O'Brien, Paul Edmond

PY - 2009

Y1 - 2009

N2 - BACKGROUND: Understanding of the effects of adjustments to laparoscopic adjustable gastric band (LAGB) volume is limited. Changes in intraluminal pressure may be important and explain patients reporting a tighter LAGB after saline is removed and an identical volume replaced. METHODS: Using high-resolution manometry, changes in the basal intraluminal pressure at the level of the LAGB in response to sequential, small alterations in LAGB volume were recorded. All fluid was removed from the LAGB and replaced, pressures and motility were reassessed. RESULTS: Sixteen patients (four males, age 45.4 +/- 13.2 years) participated. A linear increase (r (2) = 0.87 +/- 0.12) in intraluminal pressure was observed after a threshold volume was reached. The threshold volume varied considerably (1.0 to 5.8 ml). The gradient of the linear increase was 21.2 +/- 8.7 mmHg/ml. The mean basal intraluminal pressure at the level of the LAGB was initially 19.1 +/- 8.9 mmHg and increased to 37.0 +/- 20.4 mmHg (p = 0.001) after removing and replacing the same volume of saline. There was an increase in distal esophageal peristaltic pressure (123.5 +/- 34.7 vs. 157.4 +/- 52.6 mmHg, p = 0.003) and a decrease in the proportion of normal swallows (0.85 +/- 0.22 vs. 0.53 +/- 0.47, p = 0.02). Nine patients also developed adverse symptoms. CONCLUSIONS: Intraluminal pressure at the level of the LAGB is an objective measure of the restriction produced by LAGBs. The addition of fluid to the LAGB results in a linear increase in intraluminal pressure once a threshold volume is reached. The removal and replacement of the same volume of saline from the LAGB may temporarily increase intraluminal pressure.

AB - BACKGROUND: Understanding of the effects of adjustments to laparoscopic adjustable gastric band (LAGB) volume is limited. Changes in intraluminal pressure may be important and explain patients reporting a tighter LAGB after saline is removed and an identical volume replaced. METHODS: Using high-resolution manometry, changes in the basal intraluminal pressure at the level of the LAGB in response to sequential, small alterations in LAGB volume were recorded. All fluid was removed from the LAGB and replaced, pressures and motility were reassessed. RESULTS: Sixteen patients (four males, age 45.4 +/- 13.2 years) participated. A linear increase (r (2) = 0.87 +/- 0.12) in intraluminal pressure was observed after a threshold volume was reached. The threshold volume varied considerably (1.0 to 5.8 ml). The gradient of the linear increase was 21.2 +/- 8.7 mmHg/ml. The mean basal intraluminal pressure at the level of the LAGB was initially 19.1 +/- 8.9 mmHg and increased to 37.0 +/- 20.4 mmHg (p = 0.001) after removing and replacing the same volume of saline. There was an increase in distal esophageal peristaltic pressure (123.5 +/- 34.7 vs. 157.4 +/- 52.6 mmHg, p = 0.003) and a decrease in the proportion of normal swallows (0.85 +/- 0.22 vs. 0.53 +/- 0.47, p = 0.02). Nine patients also developed adverse symptoms. CONCLUSIONS: Intraluminal pressure at the level of the LAGB is an objective measure of the restriction produced by LAGBs. The addition of fluid to the LAGB results in a linear increase in intraluminal pressure once a threshold volume is reached. The removal and replacement of the same volume of saline from the LAGB may temporarily increase intraluminal pressure.

UR - http://www.springerlink.com/content/t13th34607412063/fulltext.html

U2 - 10.1007/s11695-009-9950-3

DO - 10.1007/s11695-009-9950-3

M3 - Article

VL - 19

SP - 1508

EP - 1514

JO - Obesity Surgery

JF - Obesity Surgery

SN - 0960-8923

IS - 11

ER -