Introduction: Outpatient bariatric surgery is a viable option for patients thinking about weight loss surgery. We describe our technique of 960 patients who have undergone Laparoscopic Adjustable Gastric Banding (LAGB) without using fixating sutures at the port. The implantation of polypropylene mesh allows for very little post-op pain and the lack of narcotics use post-operatively. Patients who had LAGB and mesh implantation experienced minimal pain without the need for admission to a hospital inpatient setting.
Methods: All patients undergoing LAGB underwent implantation of mesh sewn to the posterior aspect of the port device. Polypropylene mesh was placed over the 15 mm trocar site with coverage of the fascial defect. Prolene sutures were used to sew the hernia mesh to the port device. The port was placed in a superficial subcutaneous pocket to allow for easier access of port.
Results: Two patients out of 960 had a peri-port infection requiring re-siting of port. All other patients did not require narcotic pain medications to control post-op pain. Patients tolerated liquid acetaminophen for pain control in the post-op pain.
Conclusion: Implantation of mesh at the port site allows for removal of all post-op pain and the ability to remove all post-op narcotics. The use of non-narcotic pain medication decreases nausea and dysphoria after surgery. Patients also had all lap band adjustments under local anesthesia in a clinic setting as the port was easier to palpate in the more superficial position. The mesh prevents rotation of the port which has been reported as a common problem with LAGB.