Six years experience with minilaparotomy silastic ring vertical gastroplasty.
BACKGROUND: In 1994, we modified the silastic ring vertical gastroplasty (SRVG) procedure to be able to perform it through a small incision. We expected this MiniSRVG to reduce postoperative pain and discomfort, shorten hospital 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 curvature of the stomach and is done partly blindly. Certain technical maneuvers 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 differences in weight and BMI loss. The small incision in the MiniSRVG, however, shortened the median operating time (32.1 vs 38.1 minutes) and reduced greatly 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 increase in seroma formation (11.8 vs 4.50%). CONCLUSIONS: The MiniSRVG was as safe and efficient as the classic SRVG, obtaining the same BMI reduction and satisfaction.