Laparoendoscopic single-site surgery for the placement of an adjustable gastric band: a large cohort comparison.
BACKGROUND
Laparoendoscopic single-site (LESS) surgery has been shown to be a well-tolerated alternative for the placement of an adjustable gastric band. To date, only small series have suggested that this approach may provide potential clinical benefits over standard multiport laparoscopy. The objective of this study was to compare the outcomes of patients undergoing LESS adjustable gastric banding (LESS-AGB) and a cohort of patients undergoing standard multiport laparoscopic adjustable gastric banding (LAGB).


METHODS
A total of 206 patients underwent placement of an adjustable gastric band. Of these, 106 patients underwent LESS-AGB and were compared with a demographically similar cohort of 100 patients who underwent standard LAGB. Data collected included operative time, parenteral and oral narcotic consumption, duration of patient controlled analgesia (PCA) device, subjective pain scores using the 0-10 numeric pain intensity scale, and length of stay. Unpaired t test was used for analysis.


RESULTS
Compared with multiport LAGB patients, LESS-AGB patients reported significantly less pain at the first postoperative hour (P = .012), twelfth postoperative hour (P = .017), and twenty-fourth postoperative hour (P = .012), and consumed fewer oral analgesic tablets (P = .012). Operative times were significantly longer in the LESS-AGB group (P = .029). No significant differences were seen in duration of PCA, parenteral narcotic consumption, or length of stay. One LESS-AGB case required conversion to multiport laparoscopy. Complication rates were similar between the 2 groups.


CONCLUSIONS
LESS-AGB is associated with less pain and less oral analgesic consumption than multiport LAGB. Given these clinical advantages and superior cosmetic results, laparoendoscopic single-site surgery may be an attractive alternative approach for patients considering LAGB.
St. Luke's-Roosevelt Hospital Center, University Hospital of Columbia University College of Physicians and Surgeons, New York, New York.
Koji
K
Park
John N
JN
Afthinos
Syed S
SS
Razi
Elaine
E
Chan
David Y
DY
Lee
Julio A
JA
Teixeira
D000293:Adolescent; D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D010147:Pain Measurement; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
Laparoscopic adjustable gastric band; SILS; Single incision; Single port