Dynamic radioisotope scintigraphy for gastric banding adjustment

Background: Gastric banding is today a common restrictive procedure to treat morbid obesity. After operation, adjustment of the band is required to adequately restrict food intake, allowing better results. The aim of this study was to evaluate the results of a unique method of adjustment using dynamic radioisotope sclntlgraphy. Methods: 40 patients after Laparoscopic Adjustable Gastric Banding (LAGB) were prospectively divided into 2 equal groups, and the results of adjustment analyzed using the conventional method of fluoroscopic image and barium swallow (FA Group), and our proposed new method of dynamic radioisotope scintigraphy (DRS Group) using Tc99-phytate labeled plain yogurt. Results: After 6 months follow-up, the FA group lost 12.34%, while the DRS group lost 20.34% of their initial weight. In the FA group, we found that 95% of the patients needed re-adjustments versus only 25% in the DRS group (P<0.0001). Vomiting was more frequent in the FA group than in the DRS group, mean 0.65 and 0.2, respectively (P<0.009). The radiation exposure was 4 times higher in the FA group, but the cost of the 2 adjustment procedures was similar. Conclusion: DRS is a more physiologically friendly and accurate method of gastric banding adjustment than the conventional barium swallow adjustment; it also results in a better weight loss during the first 6 months after operation.