"What about Single Incision Lap Band Surgery?"

Lately there is a push in the surgical community, mostly, in my opinion, by the surgical equipment manufacturers, to perfrom LapBand surgery through a single incision.  The incision may be located in the navel (belly button), or elsewhere on the abdomen.  I've been asked by several potential LapBand patients what I think about this "less invasive" option so I figured I'd answer the question here in my blog to reach more people who may have this question as well.
I perform single incision surgery, primarily for gallbladder removal (cholecystectomy) and colon (large intestine) removal.  I've taken a course at Duke University about single incision surgery and had the opportunity to be in the operating room to observe a single incision LapBand operation.  I've also reviewed the literature about the outcomes after single incision LapBand surgery.

My opinion is that there is no advantage to single incision LapBand surgery.  There is no difference in post operative pain compared to standard minimally invasive laparoscopic LapBand surgery.  The cosmetic result is really not any different either.  The small 5 millimeter incisions used for standard laparoscopic LapBand surgery are very difficult to notice once they've healed.  Furthermore, there may be *disadvantages* to single incision LapBand surgery, since it requires more time on the operating table to perform the procedure, thereby increasing the risk of venous thrombosis in the legs (blood clots that could potentially travel to the lungs and cause life threatening pulmonary embolism), and a larger incision through the muscle layer to get all the instruments required to do the procedure through one hole, thereby increasing the risk of a hernia later on down the road.

Finally, I don't think any surgeon would argue that single incision LapBand surgery is more difficult to perform than standard laparoscopic LapBand surgery, thus the surgeon will struggle at times during the case.  As a surgeon I can honestly tell my patients that one thing you *don't want* is your surgeon to be struggling during *your operation*.  Struggling increases the risks of injuries and complications.

Bottom line, I feel that surgeons who are pushing single incision LapBand surgery are doing so in order to acheive what they believe to be a marketing advantage to get more patients to come to them.  In the end though, they may be doing their patients a disservice by doing so.

My opinion is to stick with standard laparoscopic technique when undergoing LapBand surgery.  If your surgeon is pressuring you to undergo single incision surgery for weight loss, you may want to think twice about it.