Single-incision or conventional laparoscopic adjustable gastric banding: A systematic review.

INTRODUCTION: Single-incision laparoscopic surgery (SILS) in gastric banding (SI-LAGB) has been reported to be a safe and technically feasible procedure among various operating methods. However, there is little evidence with regard to the question whether SI-LAGB has more advantages and should be recommended compared with conventional LAGB (CLAGB). Thus, this study was performed to assess the safety and efficacy of SI-LAGB. MATERIAL AND METHODS: A computerized search of the electronic databases PubMed and EMBASE was performed. Data regarding operative parameters, postoperative recovery parameters, follow-up time, percentage of excess weight loss, and postoperative complication were pooled and analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. RESULTS: Ten comparative studies including 2,073 patients (1,038 patients who received SI-LAGB and 1,035 patients who received CLAGB) were included and analyzed. Compared with CLAGB, a similar weight loss could be obtained using SI-LAGB. The postoperative complications of SI-LAGB were within the acceptable range, but one study reported one perioperative death. SI-LAGB required a longer operative time. Other outcome variables, such as blood loss, days of hospitalization, pain score, and hospitalization costs, were not significantly different between the two groups. CONCLUSIONS: SI-LAGB might be a safe and effective alternative to C-LAGB when performed by experienced surgeons, but available data do not allow to give a definitive answer and randomized controlled trials are needed.

Effects of laparoscopic adjustable gastric banding on weight loss, metabolism, and obesity-related comorbidities: 5-year results in China.

BACKGROUND: Despite some reports about the long-term metabolic outcomes after laparoscopic adjustable gastric banding (LAGB) in the Western populations, there are few reports on the Asian population whose body size and fat distribution are different. Therefore, this study was conducted to evaluate the medium-term effects of LAGB on weight loss and metabolic outcomes of obese patients with different body mass index (BMI) in China. METHODS: A retrospective study was performed to review the 5-year follow-up data of 56 patients (18 males, 38 females) who received LAGB from November 2003 to May 2013 at the Shanghai Changhai Hospital. The patients were evaluated at years 1, 3, and 5 after operation in the outpatient clinic, and the weight loss, metabolic parameters, and remission of comorbidities were measured. RESULTS: The 56 patients preoperatively had BMI of 37.4 ± 6.0 kg/m2, with BMI < 35 kg/m2 in 19 patients (BMI <35 kg/m2 group), and BMI ≥ 35 kg/m2 in 37 patients (BMI ≥ 35 kg/m2 group). The percentages of excess weight loss (%EWL) of the BMI < 35 kg/m2 group at years 1, 3, and 5 were 65.2, 65.6, and 65.7%, respectively, indicating the majority of metabolic parameters were significantly improved (P < 0.05). However, in the BMI ≥ 35 kg/m2 group, the %EWL were 37.9, 34.8, and 26.5%, respectively, except at year 1 when the metabolic parameters improved significantly (P < 0.05), those at year 3 and year 5 did not significantly improve compared with the preoperative levels. Similar results were observed in the improvement of comorbidities. CONCLUSIONS: Relatively low medium-term weight loss, metabolic improvement, and resolution or remission of obesity-related comorbidities and high reoperation rate were observed in our population of patients with BMI ≥ 35 kg/m2 who underwent LAGB.