A study published online in Surgery for Obesity and Related Diseases highlights one surgeon’s experience in using mesh fixation of the gastric band port to reduce port flip complications in patients following laparoscopic adjustable gastric banding.
Port flip, one of the more common complications associated with laparoscopic adjustable gastric banding, happens in about 2% of lap band patients. In this study, only 2 patients out of 564 required a reoperation to reposition the port, representing a 0.3% port flip rate.
Laparoscopic adjustable gastric banding is a popular type of weight loss surgery that uses a medical implant to restrict eating. The gastric band systems are made up of three primary components – the gastric band which gets fitted around the stomach, the access port which is attached to the abdominal wall, and the tubing which connects the port to the band.
The gastric band port is the part of the gastric band system that allows access to the gastric band for adding and removing fluid via a needle through the skin. Adjusting the fluid levels in the gastric band to increase or decrease restriction is a primary feature of this weight loss surgery.
Typically, the method used for attaching the port to the abdominal wall is with sutures or staples. In some patients, however, the port may become loose and/or flip over. The condition is not painful and most patients are usually not aware of the problem until they go in for a fill. The problem is that a flipped port blocks access for adjustments.
Although a flipped port is usually a minor complication that can be repaired with a simple operation under local anesthesia, it is a complication nevertheless. It is a situation that must be repaired and involves additional time and cost to the surgeon and patient.
The focus of this study was to find out whether or not using a synthetic mesh for port placement was a safe and effective method that could reduce port complications in gastric band patients.
To this end, the study followed 564 laparoscopic gastric banding patients of a private practice surgeon in the United States over a four year period, from January 2007 to January 2011. In these patients, during the operation, the gastric band port was attached to the abdominal wall using polypropylene mesh. The port was sutured to the mesh, but no additional sutures or staples were used when placing the port onto the abdominal wall.
Based on the results observed in the study, the researchers concluded mesh fixation of the gastric band port is simple, inexpensive, and highly effective with an extremely low complication rate.
Source: Surgery for Obesity and Related Diseases, “Port Fixation During Gastric Banding. 4 Year Outcome Using A Synthetic Mesh,” published online 31 October 2011.
