Article

Shoulder Pain is a Common Problem Following Laparoscopic Adjustable Gastric Band Surgery

Australian Centre for Obesity Research and Education, Monash Medical School, The Alfred Hospital, Melbourne, Australia.
Obesity Surgery (Impact Factor: 3.74). 10/2005; 15(8):1111-7. DOI: 10.1381/0960892055002149
Source: PubMed

ABSTRACT Shoulder-tip pain is commonly reported following laparoscopic adjustable gastric band (LAGB) placement. The incidence, nature and factors that may increase the risk of pain have not been explored.
A prospective extensive collection of patient characteristics and operative details was obtained from consecutive patients having band placement for severe obesity. Postoperatively, the presence and characteristics of shoulder pain were obtained using a structured interview at discharge from hospital, and at 1 and 5 weeks after placement.
66% and 21% of patients at 1 and 5 weeks respectively following surgery reported pain predominantly in the left shoulder. At 5 weeks, only 7% found the pain of concern and 5% required analgesics. There were no factors found that predicted the presence and severity of pain at 1 week. Injury to the crus of the diaphragm (OR 4.2, 1.4-12.6, P=0.01) and a past history of any upper abdominal surgery (OR 4.2, 1.5-11.7, P=0.007) independently predicted an increased risk of pain at 5 weeks.
Shoulder pain following LAGB surgery is common, usually affects the left shoulder, and can in some cases last 5 weeks or more. Avoiding injury to the crura during the procedure may prevent more prolonged pain.

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Available from: John Dixon, Aug 30, 2015
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    • "38% of patients report constant pain in the 48–72 hrs following surgery, while 28% experience it intermittently. Most patients will require analgesics or nonpharmacologic (heat packs, etc.) treatment for pain relief [3]. "
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    Evidence-based Complementary and Alternative Medicine 04/2014; 2014:120486. DOI:10.1155/2014/120486 · 1.88 Impact Factor
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    • "However, laparoscopic procedures are often associated with postlaparoscopic shoulder pain (PLSP), which may cause more discomfort to the patients than the pain at the incision sites 5. The reported incidence of PLSP was 63% after laparoscopic cholecystectomy 6, 66% after laparoscopic adjustable gastric band surgery 7, 65.5% after laparoscopic appendectomy 8 and 83% after gynecological laparoscopic surgeries 5. For improving the postoperative quality of life (QOL) for these patients, various techniques, including low-pressure insufflation, no CO2 insufflation, preemptive diaphragmatic local anesthetic irrigation and regional anesthesia to peritoneal surfaces, have been developed to reduce the PLSP 9-13. "
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    International journal of medical sciences 10/2012; 9(9):757-65. DOI:10.7150/ijms.4916 · 1.55 Impact Factor
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    • "Of the patients with abdominal pain, referred pain to the left shoulder was present, a symptom Dixon et al. [7] reported as an alteration found during the early postoperative period after LAGB placement. Diaphragm injury during surgery has been identified as an independent factor for the development of shoulder pain [7]. We believe that the inflammatory process close to the diaphragm in the case of erosion was responsible for this reported pain in our patients. "
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