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- Title
Laparoscopic Bariatric Surgery Can Be Performed Through a Single Incision: A Comparative Study.
- Authors
Rogula, Tomasz; Daigle, Christopher; Dua, Monica; Shimizu, Hideharu; Davis, Jonathan; Lavryk, Olga; Aminian, Ali; Schauer, Philip
- Abstract
Background: The application of single-incision laparoscopic surgery (SILS) in bariatric patients has been limited to less complex procedures. We evaluated the short-term outcomes of SILS sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), compared to a group of well-established minimally invasive techniques. Methods: Twenty-eight morbidly obese patients who underwent SILS SG ( n = 14) and RYGB ( n = 14) were compared to a matched control group composed of 28 cases of conventional laparoscopic surgery (CLS). A single vertical 2.5-3-cm intra-umbilical incision, three-ports placed trans-fascially, and a liver suspension technique were used to perform SILS. Results: Both groups were comparable in terms of age ( p = 0.96), gender ( p = 1.0), type of procedure ( p = 1.0), and number of comorbidities ( p = 0.63). Two (7 %) SILS patients required placement of one additional port, and no conversions to CLS or open surgery were needed. The estimated blood loss ( p = 0.48), operative time ( p = 0.33), length of hospital stay ( p = 0.79), overall 90-day perioperative complication rate ( p = 1.0), and short-term weight loss ( p = 0.53) were comparable between the two groups. In terms of pain control, the frequency of patient-controlled analgesia use in both groups was similar. However, the pain score (assessed by visual analog scale) was significantly less for SILS patients on postoperative days 1 (5.0 ± 2.1 vs. 6.5 ± 1.8; p = 0.007) and 2 (4.0 ± 2.0 vs. 5.1 ± 2.4; p = 0.49). Cosmetic satisfaction with the scar was high in the SILS group. No patients required reoperation or readmission during the 90 days after surgery. Conclusion: SILS is feasible in carefully selected bariatric patients and results in short-term outcomes comparable to those observed after CLS. Improved pain and cosmesis are potential benefits of SILS.
- Subjects
LAPAROSCOPIC surgery; BARIATRIC surgery; COMPARATIVE studies; GASTRECTOMY; GASTRIC bypass; MORBID obesity
- Publication
Obesity Surgery, 2014, Vol 24, Issue 7, p1102
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-014-1291-1