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  • Title: "No punch" technique of laparoscopic vertical banded gastroplasty for morbid obesity.
    Author: Cagigas JC, Martino E, Ingelmo A, Hernandez-Estefania R, Gomez-Fleitas M, Escalante CF.
    Journal: Obes Surg; 1999 Aug; 9(4):407-9. PubMed ID: 10484303.
    Abstract:
    BACKGROUND: This report describes the technical details and an initial evaluation of laparoscopic vertical gastroplasty modified for morbid obesity. After a surgical experience in 150 patients with open vertical banded gastroplasty (Mason's procedure), it was decided to perform a modified banded vertical gastroplasty. MATERIALS AND METHODS: Six patients were treated by this laparoscopic approach in 1997-1998. All patients were women with a mean age of 28 years (range 20-46). The mean body weight was 128 kg (range 105-146), and the mean BMI was 42.7 kg/m2 (range 35.6-53.0). Four or five 10- or 12-mm trocars were used. For all the dissection we used atraumatic ultracision (harmonic scalpel). In this procedure the technique of laparoscopic gastroplasty is performed without a circular gastric window. During the operation, 3 omental openings were made and the vertical staple-line was constructed by using a 30-mm 3-row linear stapler twice, establishing the gastric pouch. The outflow stoma was reinforced by a Gore-Tex band and calibrated to have an internal diameter of 10-15 mm. The band was sutured to itself. RESULTS: There were no deaths or complications. Operating time was 200 min (150-240). The nasogastric tube was removed at 1-2 days. The postoperative course was characterized by normal respiratory function and minimal pain in all cases. Patients were discharged 5-6 days after operation. CONCLUSIONS: Our technique excluded the circular gastric window (i.e., "no-punch") technique in the development of an effective and simple laparoscopic procedure to treat morbid obesity.
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