A Technique for Prevention of Port Complications after Laparoscopic Adjustable Silicone Gastric Banding

Background: Laparoscopic adjustable gastric banding is a safe and effective treatment method for morbid obesity. Injection port dislocation, tube perforation and access port infection are generally classified among the minor complications, although they can require a reoperation at the port-site or even at the level of the band which may have to be removed. We designed a technique to fix the port, that can avoid unnecessary complications. Methods: The port is sutured onto a polypropylene mesh, which is then cut into shape and attached to the rectus fascia in the left hypochondrium with a Tacker stapling device. From February 2000 to January 2001, 25 patients (BMI 35-60) were operated using this technique . Results: No injection port dislocation, tube perforation or access port infection has been found in these patients. Conclusion: With the larger surface area by which the port is attached to the fascia, a stable position of the port is obtained and dislocation avoided. Multiple failed attempts at port access, with resulting risk of infection, are avoided. Due to port stability, risk of incidental tube perforation is reduced. Moreover, a considerable gain of time is obtained compared with the classical suturing of the port.