Background
Roux-en-Y gastric bypass (RYGB) has proven to be an effective treatment for obesity with excellent long-term results. However, even with RYGB weight regain occurs. A method to improve the results of RYGB and minimize the chance of weight regain is by performing a banded RYGB. Better sustained weight loss is also related to higher remission of comorbidities. This study aimed to evaluate the effect of banded and non-banded RYGB on long-term weight loss results and comorbidities.

Method
A retrospective comparative data study was performed. Patients who underwent a primary RYGB between July 2013 and December 2014 and followed a 5-year follow-up program in the Dutch Obesity Clinic (DOC) were included. The patients in this cohort were divided into a banded RYGB and non-banded RYGB group. Comorbidities were assessed during screening and follow-up. After testing for normality, differences were analyzed using a two-tailed student’s t-test or a Mann-Whitney-U test, and the chi-square test or Fisher exact test.

Results
The study included 375 patients with a mean weight and body mass index (BMI) of 128.9 (±21.2) kg and 44.50 (±5.72) kg/m².  Of this group, 184 patients underwent an RYGB and 191 underwent a banded RYGB. During all follow-up moments (3 months, 1-5 years) % Total Weight Loss (%TWL) was superior in the banded group (32.6% vs 27.6% at 5 years post-operative, p <0.001). Complication rates in both study groups were similar. Comorbidity improvement or remission did not significantly differ between the two groups (p = 0.14-1.00).

Conclusion
Banded RYGB does show superior weight loss compared to a non-banded RYGB. No difference in effect on comorbidity improvement or remission was observed. Since complication rates are similar, while weight loss is significantly greater, we recommend performing a banded RYGB over non-banded RYGB.

Keywords
Bariatric Surgery, Roux-en-Y gastric bypass, silicone banding, gastric bypass, banded gastric bypass, obesity, weight loss