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- Title
Direct visual insertion of primary trocar and avoidance of fascial closure with laparoscopic Roux-en-Y gastric bypass.
- Authors
Rosenthal, R. J.; Szomstein, S.; Kennedy, C. I.; Zundel, N.
- Abstract
<bold>Background: </bold>Laparoscopic Roux-en-Y gastric bypass (RYGBP) has been used increasingly more often in the past 10 years. The authors summarize their experience and safety/complications data based on 849 laparoscopic RYGBP procedures. They also evaluate the use of the Endopath trocar in terms of trocar-site hernias, bowel obstruction, and elimination of time-consuming fascial closure.<bold>Methods: </bold>From July 2000 to December 2003, 849 laparoscopic RYGBP procedures were performed using a bladeless, 12-mm, visual entry trocar. The patients' average body mass index (BMI) was 53.2 kg/m2. The trocar ports (n = 3,744) were not closed. Perioperative and postoperative assessments were performed.<bold>Results: </bold>In this study, 74% of the patients were retained for follow-up evaluation (mean, 10 months). Among these patients, no intraoperative bowel or vascular injuries, no mortality, and two trocar-site hernias (0.2%) were found. At 1 year, the mean excess weight loss was 73.4%.<bold>Conclusions: </bold>The Endopath trocar system shows a trend toward reducing trocar-site hernias, decreasing bowel obstruction, and eliminating the need for time-consuming fascial closure, although further studies are needed to confirm these findings.
- Subjects
LAPAROSCOPY; GASTRIC bypass; LAPAROSCOPIC surgery; MORBID obesity; BODY mass index; POSTOPERATIVE care; FASCIAE (Anatomy); HERNIA; LONGITUDINAL method; SURGICAL instruments; WOUND healing; PRODUCT design; DISEASE incidence; EQUIPMENT &; supplies; PREVENTION
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2007, Vol 21, Issue 1, p124
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-005-0823-0