Belachew M, Legrand M, Vincent V, Lismonde M, Le Docte N, Deschamps V
Service de Chirurgie Universitaire, Centre Hospitalier Hutois, Huy, Belgium.
World J Surg. 1998 Sep;22(9):955-63. doi: 10.1007/s002689900499.
We introduced open adjustable silicone gastric banding (ASGB) for treatment of morbid obesity in our institution in 1991. It was done in a prospective study comparing ASGB with vertical banded gastroplasty (VBG) with regard to weight loss. After 200 cases of open ASGB and 210 VBG procedures and the encouraging weight loss results, we started laparoscopic placement of the adjustable silicone band. The initial work was done in an animal laboratory program where a new surgical protocol has been established. Details of the laparoscopic dissection around the stomach in a deep operative field and fatty atmosphere have been developed, and a laparoscopically implantable version of the adjustable silicone band (LAGB) has been devised. The first human laparoscopic ASGB procedure was performed in our institution on September 1, 1993. Altogether 350 patients had undergone adjustable silicone gastric banding (LASGB) procedures by May 1997 (277 women, 73 men). All the patients were morbidly obese, with an average preoperative weight of 118 kg (92-200 kg). The mean BMI was 43 kg/m2 (36-65 kg/m2). The conversion rate to laparotomy has been low (1.4%). Early complications have been rare, and pouch dilatation and stomach slippage have been the only significant late complications. The rate of these complications has been considerably improved by reducing the pouch volume and using more gastrogastric sutures. Evaluation of postoperative weight loss of LASGB patients compared with our VBG and ASGB (open) patients showed a similar curve.
1991年，我们在本机构引入了开放式可调节硅胶胃束带术（ASGB）用于治疗病态肥胖。这是一项前瞻性研究，比较了ASGB与垂直带状胃成形术（VBG）在减重方面的效果。在完成200例开放式ASGB手术和210例VBG手术后，鉴于令人鼓舞的减重结果，我们开始了腹腔镜下可调节硅胶束带的放置。最初的工作是在动物实验室项目中完成的，在此过程中建立了一种新的手术方案。我们已经研究出了在深部手术视野和脂肪环境下围绕胃部进行腹腔镜解剖的详细方法，并设计出了一种可通过腹腔镜植入的可调节硅胶束带（LAGB）。1993年9月1日，我们机构进行了首例人类腹腔镜ASGB手术。到1997年5月，共有350例患者接受了可调节硅胶胃束带术（LASGB）（277名女性，73名男性）。所有患者均为病态肥胖，术前平均体重为118千克（92 - 200千克）。平均体重指数为43千克/平方米（36 - 65千克/平方米）。剖腹手术的转换率较低（1.4%）。早期并发症很少见，袋状扩张和胃滑脱是仅有的严重晚期并发症。通过减小袋状体积和使用更多胃胃缝合线，这些并发症的发生率已得到显著改善。与我们的VBG和（开放式）ASGB患者相比，LASGB患者术后减重评估显示出相似的曲线。
