Laparoscopic Gastric Banding Without Visible Scar: a Short Series with Intraumbilical SILS

Abstract

Single-incision laparoscopic surgery has been developed with the aims of further reducing the invasiveness of traditional laparoscopy. The technique of lap-band placement from a single intraumbilical incision is described. Three patients underwent a single-incision laparoscopic surgery gastric banding (SILS-GB) for morbid obesity from May to September 2008. All interventions were uneventful and patients were discharged on first postoperative day, after an upper gastrointestinal series. SILS-GB is virtually scarless intervention and may be performed as a day-surgery procedure for the treatment of morbid obesity.

Bariatric single incision laparoscopic surgery – review of initial experience

“…One, by Teixeira et al [7], was excluded from the analysis as the presented data on 10 patients was further included by the authors in larger published case series [8]. Seven articles were case reports or series of cases of laparoscopic adjustable gastric banding (LAGB) using one of the SILS techniques (a total of 87 patients) [8][9][10][11][12][13][14]. Four articles described 10 cases of laparoscopic sleeve gastrectomies (LSG) using SILS technique [15][16][17][18].…”

“…Oltman et al used a left subcostal incision for port placement [12]. The incision length varied between 1.2 cm and 8.5 cm [8][9][10][11][12][13][14][15][16][17][18]. A subcostal incision, especially 8.5 cm long, certainly does not add to the cosmetic effect and many surgeons would consider it a minilaparotomy due to not fulfilling all criteria of SILS surgery.…”

Scarless Bariatric Surgery

“…We also reported two cases with SITU method where through single transumbilical incision multiple fascial punctures were performed to carry out the procedure (Figure 4) [22]. Tacchino et al used SILS port for the procedure [16]. But till now, there are no reported series comparing the outcomes of SILS LAGB and multiple-port LAGB.…”

“…However, in morbidly obese patients, the technique, which involves the dissection of the left triangular ligament of the left liver lobe, is more difficult to employ because most of these patients have a hypertrophic left liver lobe. Tacchino et al used a transfixation suture, applied on the right crus and suspended outside as a liver retractor suture [14,[16][17]. We have invented a new liver suspension tape technique via puncturing liver at peripheral area that can be used to lift even massive livers in morbidly obese patients.…”

Single Incision Laparoscopic Bariatric Surgery: Challenging the Conventional

“…The additional space also enables the surgeon to perform complete mobilization of the posterior fundus during surgery. Various liver retractions techniques have been reported over the years from application of a regular Nathanson liver retractor to the more cosmetically appeasing methods described by various surgeons (Sakaguchi et al 2008), (Huang 2011) and (Tacchino et al 2010).…”