Obesity Surgery

, Volume 22, Issue 11, pp 1695–1700 | Cite as

Single and Multiple Incision Laparoscopic Adjustable Gastric Banding: a matched comparison

  • Saurav Chakravartty
  • Beth Murgatroyd
  • David Ashton
  • Ameet Patel
Clinical Research



Single incision laparoscopic bariatric surgery has developed over the last few years, with single incision laparoscopic adjustable gastric banding (SILS-AGB) being performed most commonly. However, there are no randomised controlled trials and few matched studies comparing SILS-AGB to conventional laparoscopic multi-port multiport adjustable gastric banding (LAGB). Our aim was to study any differences in outcome and analgesic requirements between two matched groups of gastric band patients (SILS-AGB and LAGB).


Between June 2009 and September 2010, 111 patients underwent SILS-AGB and 99 patients underwent LAGB performed by a single surgeon (AGP). Patients were matched for age, sex, weight, BMI and co-morbidities. Forty six SILS-AGB and LAGB patients were included for analysis. Their outcomes were compared for operating times, conversions, analgesia requirements, morbidity and mortality.


Patients characteristics between the SILS-AGB and LAGB groups were similar with no differences in their median age (44 vs 47 years), sex (m:f; 7:39 vs 4:42), body mass index (43.1 vs 44.4 kg/m2) or co morbidities respectively. In the SILS-AGB group the median operating time (70 min) was not significantly longer than in LAGB group (61.5 min, p = 0.07). However, SILS-AGB patients used less opiates (p < 0.01) than the LAGB patients. There was no difference in morbidity, mortality or readmission rates.


SILS-AGB is a safe and feasible option and is comparable with LAGB. Post operative demand for analgesia was significantly less in the SILS-AGB group. Further comparisons of post operative pain and long term outcomes are required; however preliminary results are promising.


Single incision laparoscopic surgery Single port laparoscopic surgery laparoscopic Adjustable Gastric Banding Bariatric Surgery 


Conflict of Interests

Saurav Chakravartty: no conflict of interest

Beth Murgatroyd: no conflict of interest

David Ashton: no conflict of interest

Ameet Patel: no conflict of interest


  1. 1.
    Pfluke JM, Parker M, Stauffer JA, et al. Laparoscopic surgery performed through a single incision: a systematic review of the current literature. J Am Coll Surg. 2011;212(1):113–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Saber AA, El-Ghazaly TH. Early experience with single incision transumbilical laparoscopic adjustable gastric banding. Obes Surg. 2009;19:1442–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Saber AA, El-Ghazaly TH, Dewoolkar AV, et al. Single-incision laparoscopic sleeve gastrectomy versus conventional multiport laparoscopic sleeve gastrectomy: technical considerations and strategic modifications. Surg Obes Relat Dis. 2010;6:658–64.PubMedCrossRefGoogle Scholar
  4. 4.
    Huang CK, Yao SF, Lo CH, et al. A Novel Surgical Technique: Single-Incision Transumbilical Laparoscopic Roux-en-Y Gastric Bypass. Obes Surg. 2010;20:1429–35.PubMedCrossRefGoogle Scholar
  5. 5.
    Ren CJ, Fielding GA. Laparoscopic adjustable gastric banding: a surgical technique. J Laparoendosc Adv Surg Tech A. 2003;13(4):257–63.PubMedCrossRefGoogle Scholar
  6. 6.
    Patel AG, Murgatroyd B, Ashton WD. Single Incision Laparoscopic Adjustable Gastric Banding: 111 Cases. Surg Obes Relat Dis. 2011. doi:10.1016/j.soard.2011.06.013.
  7. 7.
    Lawlor P, Pereira J, Bruera E. Dose Ratios Among Different Opioids: Underlying Issues and an Update on the Use of the Equianalgesic Table. In: Bruera E, Portenoy RK, Bruera E, Portenoy RK, editors. Topics in Palliative Care Volume 5. New York: Oxford University Press; 2001. p. 247–76.Google Scholar
  8. 8.
    Bucher P, Pugin F, Ostermann S, et al. Population perception of surgical safety and body image trauma: a plea for scarless surgery? Surg Endosc. 2011;25:408–15.PubMedCrossRefGoogle Scholar
  9. 9.
    Nguyen NT, Hinojosa MW, Smith BR, et al. Single laparoscopic incision transabdominal (SLIT) surgery-adjustable gastric banding: a novel minimally invasive surgical approach. Obes Surg. 2008;18(12):1628–31.PubMedCrossRefGoogle Scholar
  10. 10.
    Navarra G, Pozza E, Occhionorelli S, et al. One-wound laparoscopic cholecystectomy. Br J Surg. 1997;84:695.PubMedCrossRefGoogle Scholar
  11. 11.
    Teixeira J, McGill K, Koshy N, et al. Laparoscopic single-site surgery for placement of adjustable gastric band—a series of 22 cases. Surg Obes Relat Dis. 2010;6:31–45.CrossRefGoogle Scholar
  12. 12.
    Tacchino RM, Greco F, Matera D. Laparoscopic gastric banding without visible scar: a short series with intraumbilical SILS. Obes Surg. 2010;20:236–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Keidar A, Shussman N, Elazary R, et al. Right-Sided Upper Abdomen Single-Incision Laparoscopic Gastric Banding. Obes Surg. 2010;20:757–60.PubMedCrossRefGoogle Scholar
  14. 14.
    Galvani CA, Gallo AS, Gorodner MV. Single-incision and dual-incision laparoscopic adjustable gastric band: evaluation of initial experience. Surg Obes Relat Dis. 2010. doi:10.1016/j.soard.2010.09.017.
  15. 15.
    Koh CE, Martin DJ, Cavallucci DJ, et al. On the road to single-site laparoscopic adjustable gastric banding: lessons learned from 60 cases. Surg Endosc. 2011;25(3):947–53.PubMedCrossRefGoogle Scholar
  16. 16.
    Nguyen N, Slone J, Reavis K. Comparison study of conventional laparoscopic gastric banding versus laparoendoscopic single site gastric banding. Surg Obes Relat Dis. 2010;6:503–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Saber AA, El-Ghazaly TH, Elain A, et al. Single-incision laparoscopic placement of an adjustable gastric band versus conventional multiport laparoscopic gastric banding: a comparative study. Am Surg. 2010;76(12):1328–32.PubMedGoogle Scholar
  18. 18.
    Raman SR, Franco D, Holover S, et al. Does transumbilical single incision laparoscopic adjustable gastric banding result in decreased pain medicine use? A case-matched study. Surg Obes Relat Dis. 2011;7(2):129–33.PubMedCrossRefGoogle Scholar
  19. 19.
    Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, et al. Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc. 2010;24:1842–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Bucher P, Pugin F, Buchs NC, et al. Randomized clinical trial of laparoendoscopic single-site versus conventional laparoscopic cholecystectomy. Br J Surg. 2011;98(12):1695–702.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2012

Authors and Affiliations

  • Saurav Chakravartty
    • 1
  • Beth Murgatroyd
    • 2
  • David Ashton
    • 3
  • Ameet Patel
    • 1
  1. 1.Department of Surgery (Firm 3)King’s College Hospital NHS Foundation TrustLondonUK
  2. 2.The Princess Grace HospitalLondonUK
  3. 3.Healthier Weight CentreBirminghamUK

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