Department of Surgery, University of California, Irvine, Medical Center, Orange, California 92868, USA.
Surg Obes Relat Dis. 2010 Sep-Oct;6(5):503-7. doi: 10.1016/j.soard.2009.10.001. Epub 2009 Nov 10.
Laparoscopic gastric banding is commonly performed using 5-6 abdominal trocars with enlargement of the largest trocar for implantation of the subcutaneous port. The aim of the present study was to compare the outcomes of conventional laparoscopic gastric banding with those of gastric banding performed through a single or duel incision.
From April 2008 to May 2009, 23 patients underwent laparoscopic gastric banding through a single, 3.5-4.5-cm incision with implantation of the port through the same incision. The 2 study cohorts were matched for age, gender, and body mass index. The outcome measures included the operative time, blood loss, need for conversion to 5-trocar laparoscopy, and perioperative morbidity.
Each group included 6 men and 17 women. No significant differences were found between the 2 groups with regard to preoperative body mass index (40 versus 39 kg/m(2)), operative time, blood loss, or length of hospital stay. Of the 23 patients in the single incision group, 3 (13%) required conversion to conventional 5-trocar laparoscopy. No intraoperative or postoperative complications developed in either group.
The present results have shown that in a subset of patients with a lower body mass index, adjustable gastric banding performed through a single laparoscopic incision is technically feasible and safe and does not prolong the operative time. The procedure can be performed with mostly existing ports, laparoscopic instrumentation, and visualization platforms. A prospective randomized trial is necessary to determine the clinical advantages of this less-invasive technique.
腹腔镜胃束带术通常使用 5-6 个腹部 trocar，并通过扩大最大 trocar 来植入皮下端口。本研究旨在比较传统腹腔镜胃束带术与单切口或双切口胃束带术的结果。
从 2008 年 4 月至 2009 年 5 月，23 例患者通过一个 3.5-4.5cm 的单一切口进行腹腔镜胃束带术，并通过同一切口植入端口。这两个研究组在年龄、性别和体重指数方面相匹配。主要观察指标包括手术时间、出血量、需要转换为 5 孔腹腔镜以及围手术期并发症。
每组各有 6 名男性和 17 名女性。两组患者术前体重指数（40 千克/平方米与 39 千克/平方米）、手术时间、出血量或住院时间无显著差异。在单切口组的 23 例患者中，有 3 例（13%）需要转换为传统的 5 孔腹腔镜。两组均无术中或术后并发症发生。
目前的结果表明，在一部分体重指数较低的患者中，通过单一切口腹腔镜进行可调节胃束带术在技术上是可行和安全的，并且不会延长手术时间。该手术可以使用现有的大部分端口、腹腔镜器械和可视化平台进行。需要前瞻性随机试验来确定这种微创技术的临床优势。
