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Direct visual insertion of primary trocar and avoidance of fascial closure with laparoscopic Roux-en-Y gastric bypass

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Abstract

Background

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.

Methods

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.

Results

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%.

Conclusions

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.

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Authors and Affiliations

  1. Section of Minimally Invasive Surgery and The Bariatric Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA

    R. J. Rosenthal, S. Szomstein, C. I. Kennedy & N. Zundel

Authors
  1. R. J. Rosenthal
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  2. S. Szomstein
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  3. C. I. Kennedy
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  4. N. Zundel
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Correspondence to R. J. Rosenthal.

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Rosenthal, R.J., Szomstein, S., Kennedy, C.I. et al. Direct visual insertion of primary trocar and avoidance of fascial closure with laparoscopic Roux-en-Y gastric bypass. Surg Endosc 21, 124–128 (2007). https://doi.org/10.1007/s00464-005-0823-0

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  • DOI: https://doi.org/10.1007/s00464-005-0823-0

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