A case-controlled matched-pair cohort study of single-incision and conventional laparoscopic gastric band patients in a single US center with 1-year follow-up.

INTRODUCTION

Single-incision laparoscopic gastric banding has been reported to be safe and feasible. This matched case-control study is the first to compare the outcome in terms of weight loss and comorbidity improvement and band positioning of single-incision versus conventional laparoscopic gastric banding with 1-year follow-up.

PATIENTS AND METHODS

Patients undergoing gastric banding surgery by one surgeon (S.V.) were prospectively entered into a database. Data collected included basic demographics, perioperative parameters, early and late postoperative (PO) morbidity, weight loss, and phi angle. Ten patients who underwent a single-incision gastric banding procedure were matched one-to-two with 20 patients undergoing conventional gastric banding from a database of 151 patients. Match was obtained according to gender, body mass index (BMI) ± 4 kg/m(2), age ± 8 years, and presence of at least one comorbidity in common. Generalized linear mixed models were used for statistical analysis.

RESULTS

Patients' initial characteristics were similar: SIL and conventional, respectively: sex (female:male) 9:10 and 18:20; age (years): 36.5 ± 10 and 37.5 ± 9; preoperative BMI (kg/m(2)): 41.8 ± 4 and 42.4 ± 3; weight (kg): 110.2 ± 13 and 117.9 ± 13; hospital stay (days): 1 and 1; operative time (min): 106.6 ± 24 and 100.9 ± 22. No significant differences were found in patients' BMI or excess weight loss during 1-year follow-up. The phi angles of the bands varied in a comparable range: PO day 1 (degrees): 62 ± 13 and 59 ± 15; PO week 6: 55 ± 9 and 54 ± 11, for SIL and conventional, respectively.

CONCLUSIONS

In this matched case-controlled study, single-incision laparoscopic adjustable gastric banding surgery outcomes were similar to those of the conventional multi-trocar laparoscopic operation. Band position as described by phi angle was also similar in the two groups. These results suggest that use of a single-incision approach does not compromise the results or band positioning of gastric banding surgery.