Own experience improving port implantation in laparoscopic adjustable gastric banding.

Introduction: Laparoscopic adjustable gastric banding (LAGB) is a method frequently used for treating obesity. It requires periodic band regulation associated with the need for port puncture. However, there is always a substantial risk of port rotation.

Aim: This publication presents a solution of the problem for a MiniMizer Extra band.

Material And Methods: One thousand one hundred and twenty-four individuals were operated on for obesity in the Department of Gastroenterological, Oncological and General Surgery of the Medical University of Lodz between 2005 and 2009. In 637 patients LAGB was performed. These LAGB patients were divided into three groups. In group I (20 patients) MiniMizer Extra bands were placed without port stabilization. In the second group (292 patients) MiniMizer Extra band placement with port stabilization was commenced. In the third group (325 patients) bands of other manufacturers (AMI, Inamed, Midband, Obtech) were used without port stabilization. The port was implanted into the subcutaneous tissue in the left subcostal region, medial to the left working tool trocar position.

Results: Port rotation was observed on the very first band adjustment in 3 (0.92%) and 11 (55%) patients with a band other than MiniMizer Extra (n = 325) and the first 20 patients with a MiniMizer Extra band. A different technique of port stabilization was applied in a further 292 patients on MiniMizer Extra band placement and no port rotation was noted.

Conclusions: We believe that MiniMizer additional port stabilization is necessary for its frequent rotation. Simultaneously, application of our method is easy, does not prolong the procedure significantly and secures comfortable access to the port.