Members of The Australian Institute of Weight Control have been researching the benefits of gastric banding in the morbidly obese for over a decade. We have studied the harmful effects of obesity, the health benefits of weight loss and the optimal care of the patient undertaking gastric band surgery. We have developed a wealth of knowledge regarding the best techniques for placement of the band and follow up care of patients after surgery.
We have now treated more than 7,000 patients during the last 10 years and have published many articles on the results of our studies into the outcomes of this surgery.
Research
The Australian Institute of Weight Control is committed to continuing to develop a strong research base for its clinical practice. Good research leads to excellent clinical practice, which translates to excellent care for our patients. The team at AIWC have been at the forefront of developments in Bariatric surgery for over two decades and continue to take a leadership role in the delivery of programmes to achieve lasting weight reduction.
Research Studies
- • Studies in the efficacy of the adjustable gastric band
- • Role of weight loss in the management of type 2 diabetes
- • Studies on quality of life following weight loss with the adjustable gastric band
- • Studies on pressure adjustment of bands
- • Treatment of band erosions endoscopically
- • Treatment of band slippages
- • Mechanisms of preventing wound infections
- • Gallbladder function after weight loss
- • The liver and changes after weight loss
- • New Technologies: V Block system for weight reduction
- • New Procedures: Gastric plication as an alternative to sleeve gastrectomy
- • Dietary regiments before and after bariatric surgery
- • Support groups and their effectiveness.
We have learned much from the studies conducted at the three AIWC bariatric centres including the following
Adjustable Gastric Bands back to top
Surgeons of the AIWC introduced the Swedish Adjustable gastric band to Australia in the 1990s. Since that time many patients have had effective treatment for their obesity using this device. Studies have shown:
* Gastric banding is a safe procedure.
* On average gastric banding leads to more than 50% of excess weight loss.
* Weight loss following gastric banding leads to resolution or improvement in most of the problems caused by obesity.
* Weight loss following gastric banding leads to improvement in quality of life.
Type 2 Diabetes back to top
Weight loss using either an adjustable gastric band or gastric bypass leads to better control of diabetes reduced medication and in some instances abolishes the need for medication. Ongoing studies are looking at the role of adjustable gastric bands versus gastric bypass and their effectiveness
Pressure Adjustments of Gastric Bands back to top
In future it may be possible to adjust bands by recording the pressure within the band as opposed to the volume. Initial studies are very encouraging that this will eventuate.
Endoscopic Treatment of Band Erosions back to top
When this uncommon complication occurs, endoscopic removal of the band provides the best way to deal with it as it least interferes with the upper end of the stomach and thus allow for a subsequent procedure once healing has occurred
Prevention of Wound Infections back to top
Obesity is associated with a high prevalence of wound infection after surgery. Topical application of antiseptics and intravenous antibiotics reduce the problems of infection.
Gallbladder Function after Weight Loss Surgery back to top
It has been shown that rapid weight loss is associated with increased prevalence of gallstone formation. Restricting the weight loss rate to approximately 0.5 to 1 kg weight loss per week as can be achieved with adjustable gastric bands reduces the prevalence of gallstone formation so that it is no different to that of patients who have not had surgery.
The Liver and Changes after Weight Loss back to top
Excess weight is associated with deposition of fat in the liver. A very low caloric diet prior to surgery reduces the fat content of the liver and adds to the safety of any abdominal operation. In addition following bariatric surgery successful weight loss leads to normalisation of the liver.
New Technologies : The Maestro V Block System back to top
The AIWC team have been working with Enteromedics in the development of a vagal blocking system which results in increased satiety, reduces hunger and hence is effective in weight reduction and in treating type2 diabetes and hypertension. Whilst not commercially available we look forward to the time when it will become so as this may herald the next major development in the treatment of obesity and the diseases associate with obesity.
New Procedures: Gastric Plication as an alternative to Sleeve Gastrectomy back to top
Although the sleeve gastrectomy results in weight loss of over 50% of excess weight, it is not without risk. There have been a number of reports of gastric leaks with a risk of about 1%. The gastric plication operation involves invaginating the stomach onto itself without the need to surgically remove it. It is under clinical trial investigation.
Dietary requirements before and after surgery back to top
Food products have been developed which are nutritionally sound and achieve satiety with minimal calories. These are taken prior to surgery in order to address the problems with fatty livers and then after the surgery during the healing and transition to normal diet phases. The food comes under the name of Fulfil and is recommend for all AIWC patients.
Support Groups and their effectiveness back to top
A study of the support group meetings at one of the centres has shown that support groups are by and large very effective and desirable. However in a busy world access to the support groups are a problem for many patients and ways to address this problem have been developed.
Ethical Approval
All the projects the Institute is involved in have the approval of an ethics committee e.g. the Bellberry Human Research Ethics Committee.
The most important information that comes from these studies to date is that:
- Gastric banding is a safe procedure.
- Gastric banding leads to between 50 to 60% of excess weight loss.
- Weight loss following gastric banding leads to resolution and improvement of most of the diseases caused by obesity.
- Weight loss following gastric banding leads to improvement in quality of life.
Our extensive database enables us to track a patient’s clinical assessment and progress. It also enables us to conduct research on how effective the procedure has been in terms of individual progress as well as being able to examine what the average weight loss is at any given point in time for all patients.
It must be stated that when patients information is used for research that it is "de-identified", which means that no identifying markers will be used and patients will only be identified by their file number and initials.
