Comparison study of conventional laparoscopic gastric banding versus laparoendoscopic single site gastric banding

Laparoscopic gastric banding is commonly performed using 5-6 abdominal trocars with enlargement of the largest trocar for implantation of the subcutaneous port. The aim of the present study was to compare the outcomes of conventional laparoscopic gastric banding with those of gastric banding performed through a single or duel incision.

From April 2008 to May 2009, 23 patients underwent laparoscopic gastric banding through a single, 3.5-4.5-cm incision with implantation of the port through the same incision. The 2 study cohorts were matched for age, gender, and body mass index. The outcome measures included the operative time, blood loss, need for conversion to 5-trocar laparoscopy, and perioperative morbidity.

Each group included 6 men and 17 women. No significant differences were found between the 2 groups with regard to preoperative body mass index (40 versus 39 kg/m(2)), operative time, blood loss, or length of hospital stay. Of the 23 patients in the single incision group, 3 (13%) required conversion to conventional 5-trocar laparoscopy. No intraoperative or postoperative complications developed in either group.

The present results have shown that in a subset of patients with a lower body mass index, adjustable gastric banding performed through a single laparoscopic incision is technically feasible and safe and does not prolong the operative time. The procedure can be performed with mostly existing ports, laparoscopic instrumentation, and visualization platforms. A prospective randomized trial is necessary to determine the clinical advantages of this less-invasive technique.