Port function after laparoscopic adjustable gastric banding for morbid obesity.
BACKGROUND
Laparoscopic adjustable gastric banding (LGB) has gained wide popularity, but information on port function is limited.


METHODS
In a prospective nonrandomized study, we analyzed port function and related symptoms in 50 consecutive patients with severe obesity. All patients underwent LGP in a five trocar technique. In 11 patients, the port was placed subcutaneously in the subxiphoid region. In 39 patients, the port was implanted in the left upper abdomen. Mean duration of follow-up was 2.8 years.


RESULTS
Patients (12 males and 38 females) had an initial body mass index (BMI) of 47.1 kg/m2. Puncturing the subxiphoidal port was without problems in all 11 patients. However, seven women reported pain and inconvenience when wearing a brassiere. Two underwent port reimplantation in the left upper abdomen (one due to infection; one due to pain). Among the 39 patients with abdominal port implantation, nine patients required port correction (two of them twice). The causes were port dislocation (four cases), difficult puncturing (three), tube leakage (three), and infection (one).


CONCLUSIONS
The high number of complications suggests that the port is the Achilles' heel of LGB. Ports at the subxiphoid site were easier to puncture, but frequently caused pain in female patients.
Surgical Clinic, 2nd Department of Surgery, University of Cologne, Germany. michael.korenkov@uni-koeln.de
M
M
Korenkov
S
S
Sauerland
N
N
Yücel
L
L
Köhler
P
P
Goh
J
J
Schierholz
H
H
Troidl
D000328:Adult; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011446:Prospective Studies