A Matched Case-Controlled Study of Single Incision and Conventional Laparoscopic Adjustable Gastric Band Patients in a Single U.S. Center with 1 Year Follow-Up

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:

SIL n=10


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.

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

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

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