Laparoscopic adjustable gastric banding
Laparoscopic adjustable gastric banding
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DOI：
10.1007/s002689900499
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发表时间：
1998-09-01
影响因子：
2.6
通讯作者：
Deschamps, V
中科院分区：
文献类型：
--
作者：
Belachew, M;Legrand, M;Deschamps, V
我们于1991年引进开放式可调节硅胶胃束带（ASGB）治疗病态肥胖。这是一项前瞻性研究，比较ASGB与垂直带状胃成形术（VBG）在体重减轻方面的效果。在完成200例开放性ASGB和210例VBG手术并取得令人鼓舞的减肥结果后，我们开始在腹腔镜下放置可调节硅胶带。最初的工作是在一个动物实验室项目中完成的，该项目已经建立了一个新的手术方案。详细的腹腔镜解剖周围的胃在一个深的手术领域和脂肪的气氛已经制定，腹腔镜植入版本的可调硅胶带（LAGB）已经设计出来。1993年9月1日，在我们的机构进行了第一次人类腹腔镜ASGB手术。截至1997年5月，共有350名患者接受了可调节硅胶胃处理（LASGB）手术（277名女性，73名男性）。所有患者均为病态肥胖，术前平均体重为118 kg（92-200 kg）。平均BMI为43 kg/m2（36-65 kg/m2）。中转开腹率较低（1.4%）。早期并发症很少见，而胃袋扩张和胃滑脱是唯一显著的晚期并发症。通过减少囊袋体积和使用更多的胃-胃缝合线，这些并发症的发生率已得到显著改善。LASGB患者与我们的VBG和ASGB（开放）患者相比，术后体重减轻的评估显示出相似的曲线。
We introduced open adjustable silicone gastric banding (ASGB) for treatment of morbid obesity in our institution in 1991. It was done in a prospective study comparing ASGB with vertical banded gastroplasty (VBG) with regard to weight loss. After 200 cases of open ASGB and 210 VBG procedures and the encouraging weight loss results, we started laparoscopic placement of the adjustable silicone band. The initial work was done in an animal laboratory program where a new surgical protocol has been established. Details of the laparoscopic dissection around the stomach in a deep operative field and fatty atmosphere have been developed, and a laparoscopically implantable version of the adjustable silicone band (LAGB) has been devised. The first human laparoscopic ASGB procedure was performed in our institution on September 1, 1993. Altogether 350 patients had undergone adjustable silicone gastric handing (LASGB) procedures by May 1997 (277 women, 73 men). All the patients were morbidly obese, with an average preoperative weight of 118 kg (92-200 kg). The mean BMI was 43 kg/m(2) (36-65 kg/m(2)). The conversion rate to laparotomy has been low (1.4%). Early complications have been rare, and pouch dilatation and stomach slippage have been the only significant late complications. The rate of these complications has been considerably improved by reducing the pouch volume and using more gastrogastric sutures. Evaluation of postoperative weight loss of LASGB patients compared with our VBG and ASGB (open) patients showed a similar curve.