Background
Laparoscopic adjustable gastric banding (LAGB) is increasingly performed in patients with morbid obesity. Suturing of the access-port in LAGB can be difficult and time consuming but is felt necessary by many surgeons to prevent migration and facilitate band adjustments.
Methods
Between 2003 and 2006, 226 patients underwent LAGB with the MIDband®. All surgery was performed by the pars flaccida approach. The accessport was positioned in a subcutaneous pouch adjacent to the left hypochondrial port site and was not secured. Regular follow-up and band fills were offered. All band or port-related complications were duly recorded. A patient satisfaction survey was also conducted among 50 randomly selected post-banding patients.
Results
Mean age was 41.65 years (range 18–3 years) and mean BMI was 45.85 kg/m2 (range 34.0–4.93 kg/m2).The access-port was inaccessible at first attempt in 5 (2%) patients. 4 of these required radiological imaging to identify the port orientation and 1 required multiple attempts at port puncture with subsequent re-operation due to tube puncture. 91% of patients reported no significant trouble other than mild discomfort and prominence of the port.
Conclusion
This study shows non-fixation of the access-port to be safe and effective with good patient acceptability. In addition, it avoids the need for regular X-ray localization of the port.
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References
National Institute for Clinical Excellence. Obesity: the prevention, identification, assessment and management of overweight and obesity in adults and children. NICE clinical guideline CG43, Dec 2006. http://guidance.nice.org.uk/CG43/guidance
Gastrointestinal surgery for severe obesity. National Institutes of Health Consensus Development Conference Draft Statement. Obes Surg 1991; 1: 257–6.
Korenkov M, Kneist W, Heintz A et al. Technical alternatives in laparoscopic placement of an adjustable gastric band: experience of two German university hospitals. Obes Surg 2004; 14: 806–0.
Eid GM, Gourash W, Collins JL. A novel technique for fascial fixation of laparoscopic adjustable gastric band ports. Surg Endosc 2006; 20: 697–.
Susmallian S, Ezri T, Elis M et al. Access-port complications after laparoscopic gastric banding. Obes Surg 2003; 13: 128–1.
Korenkov M, Sauerland S, Yucel N et al. Port function after laparoscopic adjustable gastric banding for morbid obesity. Surg Endosc 2003; 17: 1068–1.
Peterli R, Donadini A, Peters T et al. Re-operations following laparoscopic adjustable gastric banding. Obes Surg 2002; 12: 851–.
Fabry H, Van Hee R, Hendrickx L et al. A technique for prevention of port complications after laparoscopic adjustable silicone gastric banding. Obes Surg 2002; 12: 285–.
Spivak H, Gold D, Guerrero C. Optimization of access-port placement for the Lap-band system. Obes Surg 2003; 13: 909–2.
Nelson LG, Mehran A, Szomstein S et al. Prevention and management of access port site hernia associated with the laparoscopic adjustable gastric band. Surg Laparosc Endosc Percutan Tech 2005; 15: 174–.
Holeczy P, Novak P, Kralova A. 30% complications with adjustable gastric banding: what did we do wrong? Obes Surg 2001; 11: 748–1.
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Arvind, N., Bates, S.E., Morgan, J.D.T. et al. Fixation of the Access-Port is Not Required in Gastric Banding. OBES SURG 17, 577–580 (2007). https://doi.org/10.1007/s11695-007-9099-x
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DOI: https://doi.org/10.1007/s11695-007-9099-x