Adjustable Gastric Banding: A Single Institution Retrospective Review of Single Incision Versus Standard Laparoscopy.

Anthony M Gonzalez, MD FACS FASMBS, Jorge R Rabaza, MD FACS FASMBS, Carmen Rodriguez, RN MSHSA, Maria Fuego, RN BSN. South Miami Hospital, Baptist Health South Florida, South Miami, Florida

 Adjustable gastric banding has shown to be an effective modality for the treatment of morbid obesity and its co-morbidities with demonstrated long-term weight loss (Saber and El-Ghazaly, 2009). With progression of minimally invasive surgery (MIS), single incision laparoscopic surgery (SILS) has also shown to be successful in procedures such as cholecystectomy (Joseph et al., 2009). A retrospective review of the data, in a single institution, was performed to compare adjustable gastric banding via the innovative approach of SILS versus standard laparoscopic placement (multi port).

A total of 94 adjustable band cases (Lapband & Realize) were performed since 2007 and retrospectively reviewed to compare age, sex, body mass index (BMI), length of stay (LOS), band type, operative times, and complications. There were 56 SILS and 38 standard laparoscopic placements.

Independent t-tests comparing age (t(92)=-.589,p=.557), BMI (t(92)=.284,p=.777) and chi-square analysis comparing sex (X2(1,n=94)=.00,p=.998), band type (X2(1,n=94)=1.94,p=.164) were not statistically significant suggesting comparable groups. There was a statistically significant difference in surgical time for SILS (Md =40.00,n=56) versus standard laparoscopic (Md=45.50, n=38); (U=657.00, z=-3.139,p=.002,r=.32). There were only 3 cases with complications; all within the SILS group. These complications included intraoperative bleeding, over medication of narcotics, and tightness of band caused by fluid in band.

As demonstrated, SILS is a safe approach to gastric banding with acceptable operative times. It can be argued that, the reviewed complications in the SILS group were related to variables beyond procedure type.

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