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Single-access laparoscopic adjustable gastric band removal: technique and initial experience
Giovanni Dapri1, Haicam El Mourad, Perrine Mathonet
1Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, 322, Rue Haute, 1000, Brussels, Belgium. giovanni@dapri.net
Single-access laparoscopy (SAL) offers a safe and effective method for laparoscopic adjustable gastric band removal (LAGBR). This minimally invasive approach reduces trauma and improves surgeon ergonomics with comparable costs to traditional multiport laparoscopy.
Area of Science:
- Minimally Invasive Surgery
- Bariatric Surgery Outcomes
- Surgical Technique Innovation
Background:
- Single-access laparoscopy (SAL) is gaining traction for its potential benefits, including reduced abdominal trauma, lower incisional hernia risk, and decreased postoperative pain.
- Laparoscopic adjustable gastric band removal (LAGBR) is a procedure where SAL is being explored.
- This study reports the initial experience and technique for LAGBR using SAL.
Purpose of the Study:
- To evaluate the safety and feasibility of performing laparoscopic adjustable gastric band removal (LAGBR) using the single-access laparoscopy (SAL) technique.
- To describe the surgical technique and initial outcomes of LAGBR via SAL.
- To assess the potential benefits of SAL in terms of surgical trauma and patient recovery.
Main Methods:
- Fourteen patients underwent LAGBR using SAL between December 2009 and March 2012.
- Indications included band intolerance, pouch dilatation, and insufficient weight loss.
- A single 11-mm trocar was used through the previous port site scar, accommodating a 10-mm scope and curved instruments.
Main Results:
- All 14 patients completed LAGBR via SAL without conversion to open surgery or need for additional trocars.
- The average operative time was 24.6 minutes, with a mean final scar length of 3.6 cm.
- Two early postoperative complications occurred; mean hospital stay was 1.3 days, with no late complications during an 18-month follow-up.
Conclusions:
- Laparoscopic adjustable gastric band removal (LAGBR) can be performed safely and effectively using single-access laparoscopy (SAL).
- The SAL technique facilitates laparoscopic working triangulation and improves surgeon ergonomics.
- The cost of SAL for LAGBR is comparable to multiport laparoscopy due to the use of reusable materials.
