Abstract
Objectives
Laparoscopic adjustable gastric banding (LAGB) is a safe, controlled method for weight
loss in the morbidly obese patient. Inversion or dislodgement of the port leads to
difficulty with access for band adjustments and frequently requires reoperation. We
report our experience with port fixation to the rectus sheath of the abdominal wall
by using port/mesh fixation to prevent port site complications.
Methods
One hundred and ninety-one morbidly obese patients underwent LAGB between April 2002
and August 2005. The first group had ports fixed to the rectus fascia of the abdominal
wall with a standard 4-point suture technique. The second group had ports sutured
to a mesh, which was then tacked to the rectus sheath of the abdominal wall. Port
site complications were analyzed over a 5-month to 40-month period and compared between
the 2 groups. Intraoperative port fixation times were recorded for each technique.
Results
Thirty-nine patients in the suture fixation group encountered a 20.5% port site complication
rate, with 10.3% of the ports becoming dislodged or inverted. The mesh/tack group
consisted of 151 patients. The port site complication rate was 5.3%, with only a 1.3%
rate of port dislodgement or inversion. The port dislodgement or inversion rates were
significantly different between groups (P = .0049). The average operative times for port insertion were 12 minutes for the
sutured technique and 5 minutes for the mesh/tack technique.
Conclusions
The mesh/tack method of port fixation reduced the incidence of dislodgement and rotation
in our patient population, which resulted in greater ease of access for adjustments.
Furthermore, the mesh/tack technique is a quick, safe approach for port fixation through
a small incision.
Keywords
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Article info
Publication history
Accepted:
December 19,
2006
Received in revised form:
December 18,
2006
Received:
May 23,
2006
Identification
Copyright
© 2007 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
