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Laparoscopic adjustable gastric banding: is there a learning curve?
1Department of Surgery, Staten Island University Hospital, 65 Cromwell Avenue, Staten Island, NY 10304, USA.
Background:
To be certified for laparoscopic placement of adjustable gastric banding, surgeons must have advanced laparoscopic experience. Despite previous exposure to other kinds of laparoscopy, there may a learning curve specific to Lap-Band placement.
Methods:
Sixty consecutive patients were prospectively separated into two groups: the first 30 patients operated on (group 1) and the second 30 patients operated on (group 2).
Results:
Both groups were similar statistically in regard to gender, age, and body mass index. Operative time for group 1 was 79 +/- 31.1 min. There were 11 (37%) complications in 10 patients. Operative time for group 2 was 59 +/- 19.9 min. There were two complications (7%). All operations were completed laparoscopically. Operative time was significantly lower in group 2 ( t-test; p = 004). Complications were also significantly lower (chi-square; p = 0.005). The number of reoperations was also reduced and approached statistical significance (chi-square; p = 0.054). Readmissions, although reduced, were not statistically significant. There were no deaths in either group.
Conclusions:
Despite a surgeon's history of advanced laparoscopic experience, there is a definite learning curve associated with the laparoscopically placed adjustable gastric band.