title: Port fixation during gastric banding: 4-year outcome using a synthetic mesh.
abstract: BACKGROUND
  Laparoscopic adjustable gastric banding surgery is one of the most popular procedures for patients with morbid obesity. Although it is one of the least invasive surgical treatments for obesity, the most common reasons for reoperation are complications arising from the subcutaneous reservoir (port) used to adjust the band. Mesh fixation of the port, in which the port is sutured to a piece of mesh and then placed without anchoring sutures onto the fascia is a method of securing the port. The purpose of the present study was to review the experience of a single surgeon (S.B.) with mesh fixation in >500 patients during a 4-year period and to assess the safety and efficacy of this technique in private practice in United States.
  
  
  METHODS
  A total of 564 patients underwent laparoscopic gastric banding during a 4-year period from January 2007 to January 2011. During these operations, the subcutaneous port was affixed to the fascia by suturing the port to a small piece of polypropylene mesh and then placing the port onto the fascia without any additional anchoring sutures or staples.
  
  
  RESULTS
  Of 564 patients, only 2 required reoperation to reposition the subcutaneous port, for a .3% port flip rate. We also report the findings during elective reoperation for plastic surgery or revision surgery.
  
  
  CONCLUSIONS
  Mesh fixation of the subcutaneous port is simple, inexpensive, and highly effective and has an extremely low complication rate.
authors.affiliation: Division of Bariatric Surgery, Scripps Memorial Hospital, La Jolla, California 92037, USA.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Randhawa
authors.forename: Puneet
authors.initials: P
authors.lastname: Ghai
authors.forename: Sunil
authors.initials: S
authors.lastname: Bhoyrul
mesh_terms: D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D009767:Obesity, Morbid / Q000601:surgery*; D011182:Postoperative Care; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome