The post-operative period is particularly dangerous for obese patients. The aim of this study was to compare the immediate post-operative course after either laparoscopic or open gastroplasty. We studied retrospectively 20 and 14 consecutive patients who underwent laparoscopic or open adjustable silicone gastric banding, respectively. After the laparoscopic procedure, patients had a significantly shorter stay in the post-anaesthesia care unit (0.3 +/- 0.4 and 1.1 +/- 1 days), reduced analgesic requirements, a shorter period of intravenous catheter use (2.3 +/- 1.9 and 4.8 +/- 1.4 days), were able to walk sooner (1 +/- 0.4 and 2.1 +/- 1.6 days) and had a significantly shorter duration of in-hospital stay (5.4 +/- 2.3 and 15.8 +/- 4.5 days) than after an open procedure. This report suggests that the use of laparoscopy for gastroplasty in morbidity obese patients may significantly improve the immediate post-operative course.