Laparo-endoscopic Single Site Surgery (lesss) for Placement of Adjustable Gastric Band

Objective: To demonstrate with video presentation a Laparo-Endoscopic Single Site Surgery (LESSS) for placement of adjustable gastric band.

Method: Essentially this is a laparoscopic procedure done via one skin incision. A periumbilical skin incision is made and a small pocket is then created above the anterior fascia to accommodate multiple ports. Pneumoperitoneum is first achieved with a veres needle. Then a 15mm port is placed in order to introduce the gastric band into the abdomen. The 15mm port is then removed and the fascia closed enough to accommodate introduction of the flexible endoscope and the liver retractor. Two 5 mm ports are placed as well for working instruments. The pars flaccida technique is then employed to place the gastric band. The band is secured with gastro-gastric sutures using intracorporeal knot tying. The gastric band adjustable port is then placed on the anterior fascia leaving about a 2.5-3cm skin incision hidden in the patient’s umbilicus.

Conclusion: LESSS placement of adjustable gastric band is feasible with current surgical technology as demonstrated by this video. Single site surgical techniques are particularly attractive for adjustable gastric band placement because the gastric band port requires a slightly larger skin incision. We aim to look at differences in narcotic use, patient satisfaction, wound complication rates, and differences in weight loss between single incision placement of gastric band and traditional laparoscopic placement of adjustable gastric band in the future.

Session: Video Channel

Program Number: V049

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