Single and multiple incision laparoscopic adjustable gastric banding: a matched comparison.
BACKGROUND
Single incision laparoscopic bariatric surgery has developed over the last few years, with single incision laparoscopic adjustable gastric banding (SILS-AGB) being performed most commonly. However, there are no randomised controlled trials and few matched studies comparing SILS-AGB to conventional laparoscopic multi-port multiport adjustable gastric banding (LAGB). Our aim was to study any differences in outcome and analgesic requirements between two matched groups of gastric band patients (SILS-AGB and LAGB).


METHODS
Between June 2009 and September 2010, 111 patients underwent SILS-AGB and 99 patients underwent LAGB performed by a single surgeon (AGP). Patients were matched for age, sex, weight, BMI and co-morbidities. Forty six SILS-AGB and LAGB patients were included for analysis. Their outcomes were compared for operating times, conversions, analgesia requirements, morbidity and mortality.


RESULTS
Patients characteristics between the SILS-AGB and LAGB groups were similar with no differences in their median age (44 vs 47 years), sex (m:f; 7:39 vs 4:42), body mass index (43.1 vs 44.4 kg/m(2)) or co morbidities respectively. In the SILS-AGB group the median operating time (70 min) was not significantly longer than in LAGB group (61.5 min, p = 0.07). However, SILS-AGB patients used less opiates (p < 0.01) than the LAGB patients. There was no difference in morbidity, mortality or readmission rates.


CONCLUSIONS
SILS-AGB is a safe and feasible option and is comparable with LAGB. Post operative demand for analgesia was significantly less in the SILS-AGB group. Further comparisons of post operative pain and long term outcomes are required; however preliminary results are promising.
Department of Surgery (Firm 3), King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK. schakravartty@nhs.net
Saurav
S
Chakravartty
Beth
B
Murgatroyd
David
D
Ashton
Ameet
A
Patel
D000328:Adult; D000698:Analgesia / Q000706:statistics & numerical data*; D015992:Body Mass Index; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology*; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D015431:Weight Loss