Department of Surgery, Radboud University Nijmegen Medical Centre, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.
Obes Surg. 2011 Mar;21(3):386-90. doi: 10.1007/s11695-010-0175-2.
Access-port (AP) complications after laparoscopic adjustable gastric banding (LAGB) are often seen but seldom reported in literature. AP complications requiring additional surgery is reported in 3.6% to 24% of LAGB patients (Susmallian et al. Obes. Surg, 4:128-131, 2003; Peterli et al. Obes. Surg., 12(6):851-856, 2002; Busetto et al. Obes. Surg., 12:83-92, 2002; Mittermair et al. Obes. Surg., 19:446-450, 2009; Holeczy et al. Obes. Surg., 9:453-455, 1999; Bueter et al. Arch. Surg., 393:199-205, 2008; Launay-Savary et al. Obes Surg, 18:1406-1410, 2008; Balsiger et al. J. Gastrointest. Surg., 11:1470-1477, 2007; Szold and Abu-Abeid Surg. Endosc., 16:230-233, 2002). We evaluated the effect of fixing the AP on the pectoral fascia using the Velocity™ Injection Port on complication and re-operation rate. From January 2005 till October 2007, 619 LAGB procedures were performed using the SAGB QuickClose™. All procedures were performed by three dedicated surgeons using the pars flaccida technique. APs were placed on the fascia of the pectoral muscle using an infra-mammary incision. The AP device was fixed on the fascia using the Velocity™ Injection Port and Applier. Data was obtained retrospectively and records of 619 consecutive patients were reviewed for access-port complications. Sixty-eight AP complications were observed. Complications could be divided in four categories. Discomfort was reported in 30 patients, seven needing additional surgery. Infection contributed to 11 patients needing surgical removal of the device. Fourteen Patients with superficial infection were treated conservatively. Nine patients had inaccessible APs. Ultrasound-guided access was required in three patients. The remainder needed surgical relocation of the AP. Leakage of the tube was observed in four patients all of which needed revisional surgery. Our experience shows that fixation of the AP on the left pectoral fascia using the Velocity™ leads to a readily accessible AP with good anaesthetic and aesthetic results. In our series, 68 (11%) complications were recorded, of which 28 (4.5%) needed additional surgery.
经腹腔镜可调胃束带术（LAGB）后，接入端口（AP）并发症常见，但文献报道较少。LAGB 患者中，需要额外手术治疗的 AP 并发症发生率为 3.6%至 24%（Susmallian 等人，Obes. Surg，4:128-131, 2003；Peterli 等人，Obes. Surg.，12(6):851-856, 2002；Busetto 等人，Obes. Surg.，12:83-92, 2002；Mittermair 等人，Obes. Surg.，19:446-450, 2009；Holeczy 等人，Obes. Surg.，9:453-455, 1999；Bueter 等人，Arch. Surg.，393:199-205, 2008；Launay-Savary 等人，Obes Surg，18:1406-1410, 2008；Balsiger 等人，J. Gastrointest. Surg.，11:1470-1477, 2007；Szold 和 Abu-Abeid Surg. Endosc.，16:230-233, 2002）。我们评估了使用 Velocity™ 注射端口将 AP 固定在胸筋膜上对并发症和再次手术率的影响。从 2005 年 1 月到 2007 年 10 月，使用 SAGB QuickClose™ 进行了 619 例 LAGB 手术。所有手术均由三名专用外科医生使用薄弱部技术进行。AP 放置在胸肌筋膜的下乳房切口处。AP 设备使用 Velocity™ 注射端口和植入器固定在筋膜上。数据是回顾性获得的，对 619 例连续患者的记录进行了回顾，以评估接入端口并发症。观察到 68 例 AP 并发症。并发症可分为四类。30 名患者报告不适，其中 7 名需要额外手术。感染导致 11 名患者需要手术取出装置。14 名患者出现浅表感染，给予保守治疗。9 名患者无法触及 AP。需要超声引导进入 3 名患者。其余需要手术重新定位 AP。4 名患者出现管漏，均需再次手术。我们的经验表明，使用 Velocity™ 将 AP 固定在左胸筋膜上可获得易于触及的 AP，具有良好的麻醉和美容效果。在我们的系列中，记录了 68（11%）例并发症，其中 28（4.5%）例需要额外手术。
