Early experience with single-access transumbilical adjustable laparoscopic gastric banding.
Laparoscopic adjustable gastric banding is the most common bariatric procedure performed worldwide; since FDA approval was granted for it in June 2001, the procedure has been steadily gaining popularity in the USA. We herein report our early experience with single-access transumbilical laparoscopic gastric banding. This approach to the procedure is performed mainly through a single incision in the umbilicus. This single incision is also utilized for the implantation of the port for subsequent band adjustments. Eight patients were carefully selected (body mass indices between 35 and 45 kg/m(2) with peripheral obesity), and each underwent laparoscopic gastric banding using this single-incision transumbilical technique. The same surgeon performed all surgical interventions. For each of the eight patients, the same perioperative protocol and operative techniques were implemented. Seven out of eight attempted single-access transumbilical laparoscopic gastric banding procedures were successfully performed using this technique. Mean operative time was 105 min. One out of the eight patients required the insertion of an additional trocar. There were no mortalities or postoperative complications noted during the mean follow-up period of 2.6 months. Single-access transumbilical laparoscopic adjustable gastric banding is a safe and feasible evolving approach in a selected group of patients. The intraumbilical location of the implanted port facilitates access for subsequent adjustments and provides patients with an improved cosmetic outcome.