Laparoscopic adjustable gastric banding necessitates five small skin incisions for trocars placement. We herein present our technique of laparoscopic placement of an adjustable gastric band, which was performed primarily through a single umbilical laparoscopic incision, which was ultimately used for implanting the access port.

An intraumbilical 2.5 cm incision is made to accommodate 3 trocars and ultimately the subcutaneous access port for adjustment of gastric band. Three trocars passing through a single intraumbilical 2.5 cm incision to provide visualization as well as two working channels. The use of a flexible scope and flexible graspers are crucial for development of the retro gastric tunnel. Using an endostitch device four interrupted anterior gastrogastric sutures are placed to create the gastric plication to reduce the risk of anterior slippage. The tube band is exteriorized transumbilically and attached to the subcutaneous access port. The fascia defect is closed. The access port is secured to the anterior rectus fascia. The 2.5 cm intraumbilical incision is closed.

The operative time was 1 hour 10 minutes. A Postoperative gastrograffin swallow showed the band in the appropriate position, with free passage of contrast through the band and no extravasation. The port at the umbilicus was in good position. The patient tolerated the surgery well and was discharged the next day.

Single incision transumbilical laparoscopic adjustable gastric band is a safe and feasible evolving approach. The intraumbilical location of the incision facilitates easy access of the port for adjustment and provides patients with an improved cosmetic outcome.