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
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.
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.
Patients´ preoperative characteristics:
|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|
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|
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.
Program Number: S069