Weight Loss in Laparoscopic Adjustable Gastric Banding With Single Incision Laparoscopic Surgery Versus Conventional Technique

Jennifer Jolley, MD, Nida Ahmed, Minh Luu, MD, Amanda Francescatti, Khristi Autajay, Jonathan A Myers, MD. Rush University Medical Center

Abstract

Background
Laparoscopic adjustable gastric banding (LAGB) is an effective and commonly used bariatric surgery for weight loss in obese patients. Traditional LAGB generally involves the placement of up to five incisions. However, the advancement of surgical instrumentation and training has allowed for the development of a more minimally invasive surgical technique with single-incision LAGB (SILS LAGB). In this study, we seek to compare a cohort of conventional LAGB and SILS LAGB with regard to weight loss and complication rates in demographically similar patients.

Methods
From February 2009 to February 2010, fifty-nine patients underwent LAGB by one surgeon at an outpatient surgery center. All patients were compared by age, gender, preoperative body mass index (BMI), 30-day complication rates, and excess weight loss (EWL). Thirty-seven of the operations were performed in a conventional, five-incision LAGB technique. Twenty-two patients had SILS LAGB, via an incision placed either in the left upper abdominal quadrant or periumbilical region. We retrospectively assessed the success rates of these different techniques with regard to general rates of complications and average percentage EWL in six-month follow-up intervals.

Results
Thirty-seven patients underwent conventional LAGB (27 females, 10 males) with an average age of 41.2 years, and an average preoperative BMI of 48.2 kg/m2. The 22 patients in the SILS group (21 females, 1 male) had an average age of 43.9 years, and an average preoperative BMI of 40.3 kg/m2. The mean operative time in the SILS group was longer than the conventional LAGB group, 47.1 minutes versus the 37.4 minutes, p value of 0.0027. EWL comparisons for each group are listed below:
 

The overall percentage EWL was not statistically different between the two groups for each follow-up period. There were no complications or mortalities in either group.

Conclusions
While patients undergoing bariatric surgery may choose SILS LAGB for cosmetic purposes, this retrospective review comparing SILS LAGB to conventional LAGB demonstrates that it is just as effective in helping these patients to achieve weight loss without any added morbidity. 
 

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