title: Single-incision laparoscopic adjustable gastric banding is effective and safe: 756 cases in an academic medical center.
abstract: BACKGROUND
  Laparoscopic adjustable gastric banding (LAGB) is safe and effective. This less invasive option involving fewer incisions and umbilical approaches is coined as single-incision laparoscopic surgery (SILS). Over the last 3 years, we performed 46 % of our LAGBs as SILS with excellent results.
  
  
  METHODS
  This is a retrospective review of 1,644 LAGBs performed between 2008 and 2010. A total of 756 were performed as SILS bands (46 %) and 888 as standard (non-SILS) (54 %). Data points compared include operative time, percent of excess weight loss at 1 and 2 years, complication, and re-operation rates.
  
  
  RESULTS
  Groups were matched by age, initial BMI, and gender: 584 non-SILS and 710 SILS patients. The average operating time was 44.3 ± 19.6 min for SILS and 51.1 ± 19.4 min for non-SILS (p < 0.001). The 12-month percent excess weight loss (%EWL) for SILS was 45.0 ± 19.1; it was 40.7 ± 17.5 for non-SILS (p = 0.003). The 24 month %EWL for SILS was 54.4 ± 16.3; it was 46.4 ± 16.1 for non-SILS (p = 0.10). Complication rates were 5.6 % (40 of 710) for SILS and 4.5 % (26 of 584) for non-SILS (p = 0.34). The 30-day readmission/re-operation rates are 1 % (seven of 710) for SILS and 1.5 % (nine of 584) for non-SILS (p = 0.37). There was one death in the SILS group.
  
  
  CONCLUSIONS
  We have been performing more SILS bands over time. Our operative times and weight loss figures show that it is an efficient and effective means of weight loss. Furthermore, the data also show that the SILS approach is safe and does not increase operative time. In conclusion, SILS laparoscopic adjustable gastric banding is a safe and effective means of attaining weight loss in selected patients.
authors.affiliation: New York University Langone Medical Center, New York, NY 10016, USA. brad.schwack@gmail.com
authors.forename: Bradley F
authors.initials: BF
authors.lastname: Schwack
authors.forename: Richard
authors.initials: R
authors.lastname: Novack
authors.forename: Heekoung
authors.initials: H
authors.lastname: Youn
authors.forename: Christine Ren
authors.initials: CR
authors.lastname: Fielding
authors.forename: Marina S
authors.initials: MS
authors.lastname: Kurian
authors.forename: George A
authors.initials: GA
authors.lastname: Fielding
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D004954:Esthetics; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D061646:Operative Time; D010149:Postoperative Pain / Q000453:epidemiology*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery*; D014481:United States / Q000453:epidemiology; D015431:Weight Loss