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- Title
Two Hundred Seventy-Five Single-Incision Laparoscopic Gastric Band Insertions: What Have We Learnt?
- Authors
Murgatroyd, Beth; Chakravartty, Saurav; Sarma, Diwakar; Patel, Ameet
- Abstract
Single-incision surgery in the morbidly obese patient has not been widely adopted, but remains a popular choice amongst patients. In the bariatric patient, it presents its own surgical challenges with hepatomegaly and increased abdominal adiposity. Here, we present our experience of 275 single-incision laparoscopic gastric bands.Between June 2009 and April 2013, 275 obese patients underwent single-incision laparoscopic adjustable gastric banding through a single incision using a multichannel single port and via a pars flaccida approach. Prospective data collection was undertaken including operating time, additional ports and additional procedures undertaken.In this series, median operative time was 60 (range 34-170) min. An additional port was placed in 15 patients (5 %), including two conversions to four-port technique (0.7 %). Of these patients ( n = 15), the majority were male ( p < 0.0001). Reasons for additional port placement included bleeding and anatomical abnormalities. Additional port placement occurred more often within the first 50 cases (5/50, 10 % vs 10/225, 4 %). An umbilical incision resulted in more wound-related complications than a transverse incision in the upper abdomen ( p < 0.001). There were no 30-day mortality and minimal morbidity with two wound infections resulting in band removal.Single-incision laparoscopic adjustable gastric banding can be performed safely with minimal morbidity in the morbidly obese patient, and our technique has a high rate of success for all BMIs. Following 275 single-incision band insertions additional port placements were more commonly required in male patients, BMI >45 and earlier in the learning curve.
- Subjects
BARIATRIC surgery; LAPAROSCOPIC surgery; HEPATOMEGALY; GASTRIC banding; SURGICAL complications; HEPATIC artery
- Publication
Obesity Surgery, 2014, Vol 24, Issue 7, p1073
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-014-1208-z