Gastric Band

History and Development of the Gastric Band

The development of the gastric band is a fascinating story and Dr Lubomyr Kuzmak (1929-2006) plays a central part. Kuzmak was born in the Ukraine and emigrated to the USA in 1965. In the early 1980s he devoted his energy and skill to development of a simple and safe restrictive procedure for severe obesity – the gastric band.

In 1986 Kuzmak reported the first use of an adjustable silicone gastric band (ASGB), implanted by an open procedure. This first band was a primitive device compared with the modern gastric bands, but nevertheless the early results were very encouraging.

Professor Franco Favretti and his team began to promote the use of the “Kuzmak” ASGB in various centres around the world and between 1991 and 1994 more than 2000 gastric bands were implanted.

Towards the end of the 1980s and early 1990s, developments in laparoscopic (“keyhole”) surgery began to revolutionize the approach to abdominal surgery. Whilst the laparoscopic implantation of a gastric band was technically feasible, it was recognized that the existing “Kuzmak” ASGB was not suitable.

Between 1991 and 1993 animal studies were carried out under the direction of several pioneers (Favretti, Belachew, Cadiere and O’Brien), with the intention of producing a laparoscopically implantable gastric band – later called the LAP-BAND^®. By 1993 these early animal studies were completed and the LAP-BAND^®as we now know it was born.

Dr Lubomyr Kuzmak

The first adjustable silicone gastric band – note small inflation area and large filling chamber

First adjustable gastric band

The modern LAP-BAND® first implanted in 1993

In March 1994 the first clinical workshop on the LAP-BAND^® was held in Belgium and thereafter worldwide introduction followed. It is important to note at this point that it was Prof. Franco Favretti who was hugely influential in defining the standard laparoscopic technique for implantation of the gastric band.

In 1995 the first US Trials were initiated, but it was not until June 2001 that the device was approved for use in the US. Since the first gastric band was implanted, more than 400,000 LAP-BAND^®devices have been implanted worldwide.

In the UK, interest in weight-loss surgery in general has been very much slower to develop than in virtually all other European countries. Very few UK clinical trials on the gastric band have been published to date, though the number of centres offering the procedure has increased dramatically. The problem is that although the stomach band procedure is very safe in experienced hands, it can be dangerous when used by those who are not sufficiently familiar with the modern surgical approach to gastric banding.