S. VITHIANANTHAN, MD, D GERO, MD, J Zhang, BS, J T Machan, M Vera, md. Department of Surgery, Alpert Medical School of Brown University, The Miriam Hospital Providence RI and Service de Chirurgie Générale, Hôpital du Chablais, Monthey, Switzerland
INTRODUCTION
Single incision laparoscopic gastric banding (SIL-GB) has been reported to be safe and feasible. This matched case-control study is the first to compare the outcome in weight loss and comorbidity improvement of single versus conventional laparoscopic gastric banding with 1 year follow-up.
METHOD
Patients undergoing gastric banding surgery by one surgeon (SV) were prospectively entered into a database. Data collected included basic demographics, perioperative parameters, early and late postoperative morbidity, weight loss and phi angle. Ten patients who underwent a single incision gastric banding procedure were matched one-to-two with 20 patients undergoing conventional gastric banding from the database of 151 patients. Match was obtained according to gender, BMI ±4, age ±8, and presence of at least one comorbidity in common. Generalized linear mixed models were used for statistical analysis.
RESULTS
Patients´ preoperative characteristics:
|
SIL n=10 mean±std |
Conventional n=20 mean± std |
|
|---|---|---|
| sex (m:f) | 9:10 | 18:20 |
| age(years) | 36.5 ±10 | 37.5 ± 9 |
| Preop BMI | 41.8± 4 | 42.4 ± 3 |
| Weight (kg) | 110.2 ± 13 | 117.9 ±13 |
| OR time (min) | 106.6 ±24 | 100.9 ± 22 |
| Hosp stay (d) | 1 | 1 |
We found no significant differences in patients BMI and excess weight loss (EWL) during the 1 year follow-up.
| months | SIL BMI | CONVENTIONAL BMI | P VALUE |
| 1.5 | 38.4 | 39.0 | 0.40 |
| 3 | 36.65 | 38.35 | 0.28 |
| 6 | 36.69 | 37.25 | 0.72 |
| 12 | 34.35 | 36.71 | 0.21 |
Major complications did not occur in the cohorts, rate of minor complications (wound infection, postoperative obstruction) was comparable between SIL-GB and conventional GB, 10% and 15% respectively. The position of the gastric band (phi angle- angle between spinous process and the long axis of the band) showed no significant difference between the two groups.
| time | SIL (degres) | Conventional (degrees) |
| Phi angle at day 1 | 62 ± 13 | 59± 15 |
| phi angle at 1.5 monthspostop | 55 ± 9 | 54 ± 11 |
Conclusion
In our matched case controlled study, Single incision laparoscopic adjustable gastric banding surgery outcomes are similar to the conventional multi-trocar laparoscopic operation. Even when comparing the angle the of the band there were no statistical differences in both techniques. It is noteworthy that in both groups we noticed a “settling” effect of the angle, where the phi-angle decreased in angulation after 6 weeks.
Session: SS12
Program Number: S069