Arvind Nitin, Bates Sharon E, Morgan Justin D T, Hewin David F, Frering Vincent M, Norton Sally A
Department of Upper Gastrointestinal and Laparoscopic Surgery, Southmead Hospital, Bristol, UK.
Obes Surg. 2007 May;17(5):577-80. doi: 10.1007/s11695-007-9099-x.
Laparoscopic adjustable gastric banding (LAGB) is increasingly performed in patients with morbid obesity. Suturing of the access-port in LAGB can be difficult and time consuming but is felt necessary by many surgeons to prevent migration and facilitate band adjustments.
Between 2003 and 2006, 226 patients underwent LAGB with the MIDband. All surgery was performed by the pars flaccida approach. The access-port was positioned in a subcutaneous pouch adjacent to the left hypochondrial port site and was not secured. Regular follow-up and band fills were offered. All band or port-related complications were duly recorded. A patient satisfaction survey was also conducted among 50 randomly selected post-banding patients.
Mean age was 41.65 years (range 18-73 years) and mean BMI was 45.85 kg/m2 (range 34.0-74.93 kg/m2). The access-port was inaccessible at first attempt in 5 (2%) patients. 4 of these required radiological imaging to identify the port orientation and 1 required multiple attempts at port puncture with subsequent re-operation due to tube puncture. 91% of patients reported no significant trouble other than mild discomfort and prominence of the port.
This study shows non-fixation of the access-port to be safe and effective with good patient acceptability. In addition, it avoids the need for regular X-ray localization of the port.
腹腔镜可调节胃束带术（LAGB）在病态肥胖患者中的应用越来越广泛。LAGB中接入端口的缝合可能困难且耗时，但许多外科医生认为这对于防止移位和便于束带调整是必要的。
2003年至2006年间，226例患者接受了使用MIDband的LAGB手术。所有手术均采用松弛部入路。接入端口放置在左季肋部端口部位附近的皮下袋中，未进行固定。进行定期随访并进行束带填充。所有与束带或端口相关的并发症均被妥善记录。还对50例随机选择的束带术后患者进行了患者满意度调查。
平均年龄为41.65岁（范围18 - 73岁），平均体重指数为45.85kg/m²（范围34.0 - 74.93kg/m²）。5例（2%）患者首次尝试时无法找到接入端口。其中4例需要进行放射影像学检查以确定端口方向，1例因穿刺管穿刺需要多次尝试端口穿刺并随后再次手术。91%的患者报告除了端口轻度不适和突出外没有明显问题。
本研究表明接入端口不固定是安全有效的，患者接受度良好。此外，它避免了对端口进行定期X线定位的需要。
