Six years experience with minilaparotomy silastic ring vertical gastroplasty

Background: In 1994, we modified the silastic ring vertical gastroplasty (S RVG) procedure to be able to perform it through a small incision,We expecte d this MiniSRVG to reduce postoperative pain and discomfort, shorten hospit al stay and cost, and reduce scars and overall morbidities, Methods: From October 1991 to December 1999, 893 patients were operated for morbid obesity. From October 1991 to December 1993, 111 patients underwent the classic Eckhout SRVG, From January 1994 to February 1999, 782 patients underwent the MiniSRVG, in which the dissection is limited to the lesser c urvature of the stomach and is done partly blindly. Certain technical maneu vers were done to facilitate the procedure and to shorten the incision. Results: Immediate postoperative complications and overall morbidities were similar in both series. Long-term follow-up showed no significant differen ces in weight and BMI loss. The small incision in the MiniSRVG, however, sh ortened the median operating time (32.1 vs 38.1 minutes) and reduced greatl y the incision size (6.5 vs 18 cm), the postoperative pain (1.2 vs 2.6 days ), the hospital stay (3.0 vs 5.1 days), the evisceration rate (0.1 vs 2.7%) and incisional hernia rate (5.4 vs 15.8%). The only side-effect was an inc rease in seroma formation (11.8 vs 4.50%). Conclusions: The MiniSRVG was as safe and efficient as the classic SRVG, ob taining the same BMI reduction and satisfaction.