title: Does transumbilical single incision laparoscopic adjustable gastric banding result in decreased pain medicine use? A case-matched study.
abstract: BACKGROUND
  We report on our initial experience of laparoscopic adjustable gastric banding performed through a single transumbilical incision of approximately 2.5 cm. All single incision bands were placed using the Covidien SILS Port™ and the Allergan Lap-Band(®). The purpose of the present study was to report on the analgesic use after single-incision laparoscopic surgery (SILS) adjustable gastric banding versus that after conventional laparoscopic gastric banding at a community hospital.
  
  
  METHODS
  A retrospective review of postoperative pain medication use and the time to return to work was conducted of 24 consecutive SILS adjustable gastric banding procedures compared with 24 traditional 5-incision laparoscopic adjustable gastric banding procedures.
  
  
  RESULTS
  The patients in both groups were evenly matched for age, body mass index, and co-morbidities. All patients were discharged home on postoperative day 1. No complications developed. The mean patient-controlled analgesia morphine use during hospitalization for the SILS group was 33 ± 19.22 mg versus 49 ± 23.78 mg in the traditional group (P <.05). The mean period of postoperative pain medication use for the SILS group was 2 days versus 5 days for the traditional group (P <.05). However, the mean period to return to work was 9.5 days for the SILS group versus 11 days for the traditional group (P = NS).
  
  
  CONCLUSIONS
  Transumbilical single-incision laparoscopic adjustable gastric banding with mechanical port fixation resulted in significantly decreased postoperative pain medication use compared with traditional laparoscopic gastric banding with suture fixation of the band port. Also, the patients tended to return to work earlier after SILS gastric banding.
authors.affiliation: Department of Surgery, Bronx-Lebanon Hospital Center, Bronx, New York, USA. shankarrraman@gmail.com
authors.forename: Shankar R
authors.initials: SR
authors.lastname: Raman
authors.forename: Donna
authors.initials: D
authors.lastname: Franco
authors.forename: Spencer
authors.initials: S
authors.lastname: Holover
authors.forename: Shawn
authors.initials: S
authors.lastname: Garber
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000295:instrumentation*; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D009767:Obesity, Morbid / Q000601:surgery; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery*
chemical_list: D000700:Analgesics