Laparoendoscopic single-site surgery for the placement of an adjustable gastric band: a large cohort comparison

• Published in: Surgery for obesity and related diseases Vol. 9; no. 5; pp. 686 - 691
• Main Authors: Park, Koji, M.D, Afthinos, John N., M.D, Razi, Syed S., M.D, Chan, Elaine, M.D, Lee, David Y., M.D, Teixeira, Julio A., M.D., F.A.C.S
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2013
• Subjects: Adolescent; Adult; Aged; Analgesia, Patient-Controlled; Female; Gastroenterology and Hepatology; Gastroplasty - methods; Humans; Laparoscopic adjustable gastric band; Laparoscopy - methods; Length of Stay - statistics & numerical data; Male; Middle Aged; Obesity, Morbid - surgery; Operative Time; Pain Measurement; Retrospective Studies; SILS; Single incision; Single port; Surgery; Treatment Outcome; Weight Loss; Single port; Single incision; SILS; Laparoscopic adjustable gastric band
• ISSN: 1550-7289; 1878-7533
• DOI: 10.1016/j.soard.2012.11.009

Abstract Background Laparoendoscopic single-site (LESS) surgery has been shown to be a well-tolerated alternative for the placement of an adjustable gastric band. To date, only small series have suggested that this approach may provide potential clinical benefits over standard multiport laparoscopy. The objective of this study was to compare the outcomes of patients undergoing LESS adjustable gastric banding (LESS-AGB) and a cohort of patients undergoing standard multiport laparoscopic adjustable gastric banding (LAGB). Methods A total of 206 patients underwent placement of an adjustable gastric band. Of these, 106 patients underwent LESS-AGB and were compared with a demographically similar cohort of 100 patients who underwent standard LAGB. Data collected included operative time, parenteral and oral narcotic consumption, duration of patient controlled analgesia (PCA) device, subjective pain scores using the 0–10 numeric pain intensity scale, and length of stay. Unpaired t test was used for analysis. Results Compared with multiport LAGB patients, LESS-AGB patients reported significantly less pain at the first postoperative hour ( P = .012), twelfth postoperative hour ( P = .017), and twenty-fourth postoperative hour ( P = .012), and consumed fewer oral analgesic tablets ( P = .012). Operative times were significantly longer in the LESS-AGB group ( P = .029). No significant differences were seen in duration of PCA, parenteral narcotic consumption, or length of stay. One LESS-AGB case required conversion to multiport laparoscopy. Complication rates were similar between the 2 groups. Conclusion LESS-AGB is associated with less pain and less oral analgesic consumption than multiport LAGB. Given these clinical advantages and superior cosmetic results, laparoendoscopic single-site surgery may be an attractive alternative approach for patients considering LAGB. (Surg Obes Relat Dis 2013;0;000–00.) © 2013 American Society for Metabolic and Bariatric Surgery. All rights reserved.