Obesity Surgery

, Volume 20, Issue 6, pp 757–760 | Cite as

Right-Sided Upper Abdomen Single-Incision Laparoscopic Gastric Banding

  • Andrei KeidarEmail author
  • Noam Shussman
  • Ram Elazary
  • Avraham I. Rivkind
  • Yoav Mintz
Short Communication



Single-incision laparoscopic surgery (SILS) was recently implemented for performing gastric banding. However, concern exists regarding the safety of single-incision laparoscopic adjustable gastric banding (SILS-LAGB) compared to standard laparoscopy, and the operative technique is still evolving. We describe our preliminary experience of a new technique for SILS gastric banding based on a unique incision location, which allows a better view and improved dissection capability.


During a period of 6 months, ten patients underwent SILS-LAGB in our institution. The operative technique consisted of a 4-cm skin incision placed in the right upper quadrant (RUQ), starting from the midline and extending to the right, located above the mid-distance between the xiphoid and umbilicus. Through that incision, three trocars (two 5-mm trocars and one 15 mm) are inserted. The liver retraction was achieved through the additional subxiphoid skin puncture wound using Nathanson retractor.


Ten patients (eight females, two males) underwent SILS-LAGB. Mean age was 31.4 years (21–49) and mean BMI 40.9 kg/m2 (39–44). In nine out of ten patients, the procedure was completed through the original skin incision. In one case, one additional trocar was inserted due to poor surgical field visualization. The operative time declined from 80 to 60 min along the learning curve. The mean hospital stay was 1.1 days (1–2). There was no mortality or morbidity.


The location of the incision in the RUQ enabled a better view of the retrogastric tunnel and facilitated the dissection, and therefore should be of comparable safety to a standard laparoscopic procedure.


Gastric banding Single-incision laparoscopic surgery Morbid obesity 



We have neither conflict of interests nor financial disclosure to make.


  1. 1.
    Nguyen NT et al. Single laparoscopic incision transabdominal surgery—adjustable gastric banding: a novel minimally invasive surgical approach. Obes Surg. 2008;18:1628–31.CrossRefPubMedGoogle Scholar
  2. 2.
    Nguyen NT et al. Laparoscopic transumbilical sleeve gastrectomy without visible abdominal scars. Surg Obes Relat Dis. 2008;5:275–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Nguyen NT et al. Laparoscopic transumbilical cholecystectomy without visible scars. J Gastrointest Surg. 2008;13:1125–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Kim E et al. Minimal-scar laparoscopic adjustable gastric banding (LAGB). Obes Surg. 2008;19:500–3.CrossRefPubMedGoogle Scholar
  5. 5.
    De la Torre RA, Satgunam S, Morales M, et al. Transumbilical single-port laparoscopic adjustable gastric band placement with liver suture retractor. Obes Surg. 2009;19(12):1707–10.CrossRefPubMedGoogle Scholar
  6. 6.
    Tacchino RM, Greco F, Matera D. Laparoscopic gastric banding without a visible scar: a short series with intraumbilical SILS. Obes Surg. 2010;20(2):236–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Chapman AE et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery. 2004;135:326–51.CrossRefPubMedGoogle Scholar
  8. 8.
    Weiner R et al. Outcome after laparoscopic adjustable gastric banding—8 years experience. Obes Surg. 2003;13:427–34.CrossRefPubMedGoogle Scholar
  9. 9.
    Boschi S, Fogli L, Berta RD, et al. Avoiding complications after laparoscopic esophago-gastric banding: experience with 400 consecutive patients. Obes Surg. 2006;16(9):1166–70.CrossRefPubMedGoogle Scholar
  10. 10.
    Avinoah E, Mizrachi S. Technical tips for laparscopic gastric banding: a 6 years experience in 2800 patients by a single surgical team. Am J Surg. 2007;193:160–5.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2010

Authors and Affiliations

  • Andrei Keidar
    • 1
    Email author
  • Noam Shussman
    • 1
  • Ram Elazary
    • 1
  • Avraham I. Rivkind
    • 1
  • Yoav Mintz
    • 1
  1. 1.Department of General SurgeryHadassah-Hebrew University Medical CenterJerusalemIsrael

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