Early Experience with Single-Access Transumbilical Adjustable Laparoscopic Gastric Banding
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Early Experience with Single-Access Transumbilical Adjustable Laparoscopic Gastric Banding Alan A. Saber & Tarek H. El-Ghazaly
Received: 13 April 2009 / Accepted: 15 June 2009 / Published online: 15 July 2009 # Springer Science + Business Media, LLC 2009
Abstract Background Laparoscopic adjustable gastric banding is the most common bariatric procedure performed worldwide; since FDA approval was granted for it in June 2001, the procedure has been steadily gaining popularity in the USA. We herein report our early experience with single-access transumbilical laparoscopic gastric banding. This approach to the procedure is performed mainly through a single incision in the umbilicus. This single incision is also utilized for the implantation of the port for subsequent band adjustments. Methods Eight patients were carefully selected (body mass indices between 35 and 45 kg/m2 with peripheral obesity), and each underwent laparoscopic gastric banding using this single-incision transumbilical technique. The same surgeon performed all surgical interventions. For each of the eight patients, the same perioperative protocol and operative techniques were implemented. Results Seven out of eight attempted single-access transumbilical laparoscopic gastric banding procedures were successfully performed using this technique. Mean operative time was 105 min. One out of the eight patients required the insertion of an additional trocar. There were no mortalities or postoperative complications noted during the mean follow-up period of 2.6 months. Conclusion Single-access transumbilical laparoscopic adjustable gastric banding is a safe and feasible evolving approach in a selected group of patients. The intraumbilical location of the implanted port facilitates access for subsequent adjustA. A. Saber (*) : T. H. El-Ghazaly General Surgery, Kalamazoo Center for Medical Studies, Michigan State University, 1000 Oakland Drive, Kalamazoo, MI 49008, USA e-mail: [email protected]
ments and provides patients with an improved cosmetic outcome. Keywords Single incision surgery . Single port access . Laparoendoscopic single site . Natural orifice transumbilical . Transumbilical . Laparoscopic banding . Bariatric surgery
Introduction Laparoscopic adjustable gastric banding is the most common bariatric procedure performed worldwide; since FDA approval was granted for it in June 2001, the procedure has been steadily gaining popularity in the USA [1, 2]. A significant growth was noted in the number of laparoscopic adjustable gastric banding procedures between 2004 and 2007 with an increase of 329% compared to an increase of 125% for laparoscopic gastric bypass procedures [3]. Surgeons and patients alike are attracted to the innate simplicity, adjustability, and reversibility of the procedure in addition to its effectiveness as a weight loss modality for the morbidly obese [4]. As with most laparoscopic procedures, trocar reduction strategies in bariatric surgery are designed to develop less invasive techniques to augment the existin
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