M Korenkov1, W Kneist, A Heintz, Th Junginger. 1. Department of Visceral Surgery, University of Mainz, Langenbeckstrasse 1, D-55101 Mainz, Germany. korenkov@ach.klinik.uni-mainz.de
Abstract
BACKGROUND: The technique of laparoscopic adjustable gastric banding (LAGB), although relatively well standardized, has some "weak points". METHODS: We analysed the experience of 2 German university clinics in order to suggest technical alternatives that can be helpful in difficult situations. RESULTS: Between April 1997 and May 2002 115 patients in Cologne (87 females, 28 males) with median BMI 49.5 kg/m(2) and mean age 39 years (19-54), and 112 patients in Mainz (91 females, 21 males) with median BMI 48 kg/m(2) and mean age 35 years (18-57) underwent LAGB, using the Lap-Band. LAGB was performed through 5 ports (3 10-mm, 1 18-mm, and 1 5-mm in Cologne and 4 10-mm and 1 18-mm port in Mainz). The pars flaccida technique by means of a fan-shaped Endo-Retractor was used in both clinics. Mean duration of follow-up was 3.2 years (SD 1.0) in the Cologne group with complete investigation in all except 4 patients. In the Mainz group, mean duration of follow-up was 2.7 years (SD 1.0) with complete investigation in all except 9 patients. CONCLUSIONS: Some technical aspects such as induction of pneumoperitoneum, band position, band fixation, band malposition and port-related complications are discussed.
BACKGROUND: The technique of laparoscopic adjustable gastric banding (LAGB), although relatively well standardized, has some "weak points". METHODS: We analysed the experience of 2 German university clinics in order to suggest technical alternatives that can be helpful in difficult situations. RESULTS: Between April 1997 and May 2002 115 patients in Cologne (87 females, 28 males) with median BMI 49.5 kg/m(2) and mean age 39 years (19-54), and 112 patients in Mainz (91 females, 21 males) with median BMI 48 kg/m(2) and mean age 35 years (18-57) underwent LAGB, using the Lap-Band. LAGB was performed through 5 ports (3 10-mm, 1 18-mm, and 1 5-mm in Cologne and 4 10-mm and 1 18-mm port in Mainz). The pars flaccida technique by means of a fan-shaped Endo-Retractor was used in both clinics. Mean duration of follow-up was 3.2 years (SD 1.0) in the Cologne group with complete investigation in all except 4 patients. In the Mainz group, mean duration of follow-up was 2.7 years (SD 1.0) with complete investigation in all except 9 patients. CONCLUSIONS: Some technical aspects such as induction of pneumoperitoneum, band position, band fixation, band malposition and port-related complications are discussed.
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