Single-site Laparoscopic Gastric Band Versus Multiport Laparoscopic Gastric Band: A Matched Retrospective Study

Anthony M Gonzalez, MD, FACS, FASMBS, Jorge R Rabaza, MD, FACS, FASMBS, Rey J Romero, MD, Pedro E Garcia Quintero, MD, Christian Hernandez Mucia, MD. Baptist Health South Florida.

 INTRODUCTION
The purpose of this study is to compare the outcomes of laparoscopic single-site gastric band (LSSGB) with a cohort of patients undergoing multiport laparoscopic gastric band (MLGB). Laparoscopic Gastric Band Placement has already proven its efficacy for the treatment of morbid obesity and is one of the most common bariatric procedures performed worldwide. In addition, laparoscopic single-site surgery has been shown to be well-accepted alternative for abdominal procedures, specifically cholecystectomy. However, in bariatric surgery, only small series and a few articles have compared the outcomes of patients undergoing LSSGB compared to its counterpart standard multisite laparoscopic adjustable gastric band.

METHODS
A total of 146 patients underwent placement of adjustable gastric band. Of these, 107 underwent LSSGB and were compared with 39 similar MLGB. A single surgeon, in one hospital, performed all the surgeries. LSSGB were performed from November 2008 to November 2012, while MLGB occurred May 2008 to July 2011. Data collection included demographics, comorbidities, surgical time, hospital length of stay, and complication rate.

RESULTS
There were 68 (63.5%) vs 24 (61.5%) females (p=0.828); age was 42.9 ±12.2 (range 17-71) vs 41.2 ±12.4 (range 21-64) (p=0.179); and BMI was 43.9 ±6.6 (range 33-57.7) vs 44.2 ±6.7 (range 35.2-68.1) (p=0.275) for LSSGB and MLGB respectively. There were 21(19.7%) vs 9 (23.0%) patients with diabetes mellitus (p=0.591); 56 (52.3%) vs 18 (46.1%) with hypertension (p=0.511); sleep apnea 18 (16.8%) vs 6 (15.3%) (p=0.823); presence of previous abdominal surgery 52 (48.5%) vs 17 (43.5%) (p=0.586) for LSSGB and MLGB respectively. Total surgical time was recorded in 52.9 ± 21.9 (range 29-112) vs 52.4 ± 23.8 (range 29-113) (p=0.167) for LSSGB and MLGB. Intraoperative complications were seen in 2 (1.8%) LSSGB vs 1 (2.5%) MLGB (p=0.327); Reoperations due to complications were seen in 11 (10.2%) vs 4 (10.2%) (p=0.986); Incisional hernia was 2 (1.8%) vs 0 (p=0.389) for LSSGB and MLGB respectively; No conversions occurred in the LSSGB group. Follow up was 36.9 ± 11.8 (range 55 – 7) and 38.3 ± 9.5 (range 61-23) for LSSGB and MLGB respectively (p=0.231)

CONCLUSIONS
LSSG may be an attractive alternative for gastric band placement since it has similar outcomes to MLGB with better aesthetic results.

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