Swedish adjustable gastric banding: A preliminary experience

Background: The authors have been performing bariatric surgery for 15 years; since February 1992 they have carried out laparoscopic gastric banding (LGB) with a silastic band. Good experience with the LGB combined with everyday laparoscopic activity in their institution persuaded them to try laparoscopic placement of the Swedish adjustable gastric band (SAGB). Methods: The surgical procedure is the same as that for laparoscopic gastric banding except for the use of a 15 mm trocar that is required to introduce the band, and the need to place a port that is connected to the band via a wide loop tube; the port is place subcutaneously and is supported by the lower part of the sternum. The authors do not use any abdominal drain nor a naso-gastric tube. At surgery the band is left empty, and filling is usually not started until 4 weeks after surgery. The patient is immediately mobilized and begins a liquid diet the evening after the operation. The patients are usually discharged from hospital on the first postoperative day. Results: Over 8 months, 24 patients underwent SAGE, with mean BMI 44.69 and mean operating time 45 minutes (range 30-75). No early complications occurred. Preliminary results in this small series show BMIs of 38.65 and 34.60 at 3 and 6 months postoperation. Conclusion: SAGE appears for be a good method for obesity surgery. It is easy to perform and is associated with a low operative risk. Provided that the band is put in the right place, weight loss can be adjusted to patient comfort.