Advertisement

Obesity Surgery

, Volume 19, Issue 12, pp 1707–1710 | Cite as

Transumbilical Single-Port Laparoscopic Adjustable Gastric Band Placement with Liver Suture Retractor

  • Roger A. de la TorreEmail author
  • Shean Satgunam
  • Mario P. Morales
  • C. Liam Dwyer
  • J. Stephen Scott
Technical Innovation

Abstract

Background

The evolution of single-incision laparoscopic surgery (SILS) has no doubt been impacted by the decrease or elimination of incisions seen with natural orifice transluminal endoscopic surgery (NOTES). SILS upholds the principal advantages of minimal access surgery including shortened hospital stays, the potential for decreased postoperative pain, and cosmetically acceptable scars by reducing large or multiple incisions to a relatively small, single one.

Methods

As opposed to NOTES, SILS does not violate a natural orifice and so the potential for contamination is identical to that of laparoscopy. SILS also utilizes familiar technology regarding ports and instruments which make technical adaptation easier and costs remain essentially unchanged. Standard laparoscopic techniques for gastric band placement use up to six ports in various configurations to safely accomplish this procedure. We describe a 40-year-old female with a body mass index of 41 who underwent placement of a gastric band for weight reduction via a single incision. A novel liver retractor technique eliminated one of the typical incisions utilized in other described “single-incision” techniques.

Results

The total number of trocars used at the sole, transumbilical incision was three. The operative time was 58 min. There were no intraoperative or postoperative complications. The patient was discharged on postoperative day 1.

Conclusions

Single-incision transumbilical placement of gastric band is safe and technically feasible. Evolution of this technique with improved instrumentation will facilitate its adoption.

Keywords

Laparoscopic Single incision Single access Gastric band Transumbilical Transabdominal 

References

  1. 1.
    Piskun G, Rajpal S. Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A. 1999;9:361–4.CrossRefGoogle Scholar
  2. 2.
    Nguyen NT, Hinojosa MW, Smith BR, et al. Single laparoscopic Incision transabdominal surgery—adjustable gastric banding; a novel minimally invasive surgical approach. Obes Surg. 2008;18:1628–31.CrossRefGoogle Scholar
  3. 3.
    Nguyen NT, Hinojosa MW, Smith BR, et al. Laparoscopic transumbilical sleeve gastrectomy without visible abdominal scars. Surg Obes Relat Dis. 2008;5:275–7.CrossRefGoogle Scholar
  4. 4.
    Nguyen NT, Hinojosa MW, Smith BR, et al. Laparoscopic transumbilical cholecystectomy without visible scars. J Gastrointest Surg. 2008;13:1125–8.CrossRefGoogle Scholar
  5. 5.
    Nguyen NT, Hinojosa MW, Smith BR, et al. A single-port technique for laparoscopic extended staple appendectomy. Surg Innovat. 2009;16:78–81.CrossRefGoogle Scholar
  6. 6.
    Kim E, Kim D, Lee S, et al. Minimal-scar laparoscopic adjustable gastric banding (LAGB). Obes Surg. 2008;19:500–3. doi: 10.1007/s11695-008-9713-6.CrossRefGoogle Scholar
  7. 7.
    Fischer JE, Kirby BI. Mastery of surgery. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2007.Google Scholar

Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Roger A. de la Torre
    • 1
    Email author
  • Shean Satgunam
    • 1
  • Mario P. Morales
    • 1
  • C. Liam Dwyer
    • 1
  • J. Stephen Scott
    • 1
  1. 1.MC422—Department of SurgeryUniversity of MissouriColumbiaUSA

Personalised recommendations