Laparoscopic single-site surgery for placement of adjustable gastric band—a series of 22 cases
Received 24 December 2008; received in revised form 19 February 2009; accepted 24 March 2009. published online 17 April 2009.
Abstract
Background
We present a series of 22 patients who underwent laparoendoscopic single-site (LESS) surgery for placement of an adjustable gastric band at a U.S. university hospital.
Methods
From December 2007 to December 2008, LESS surgery, through a transumbilical incision, to place an adjustable gastric band was performed on 22 patients under institutional review board approval. Multiple ports were placed through a single incision in the umbilicus to allow for liver retraction, visualization, and the working instruments. None of the critical steps of the standard pars flaccida technique were altered.
Results
A total of 22 patients were carefully selected and included 20 women and 2 men, with an age range of 18–67 years (mean 42). The mean body mass index was 42 kg/m2 (range 35–45). The exclusion criteria included hepatomegaly, central obesity, previous abdominal surgery, and super-obesity. The mean operative time was 84 minutes (range 53–111). All patients were discharged home within the 23-hour admission, and no perioperative complications were noted. In addition, no wound-related complications developed. One patient required conversion to conventional laparoscopy. No intraoperative or postoperative complications occurred.
Conclusion
In our experience, LESS surgery for adjustable gastric band placement shows this technique to be both feasible and safe in selected patients to date. Although technical limitations exist that will be improved on, additional studies are needed to compare LESS surgery for placement of an adjustable gastric band with traditional laparoscopic techniques.
Department of Surgery, St. Luke's-Roosevelt Hospital Center, New York, New York
Reprint requests: Julio Teixeira, MD, FACS, Department of Surgery, St. Luke's-Roosevelt Hospital Center, 1090 Amsterdam Avenue, 10th Floor, New York, NY 10023
Ethicon Endosurgery provided an educational grant for a minimally invasive surgery fellowship.
ABSTRACT