Umbilical Single-Port Sleeve Gastrectomy as a Standardized Procedure: How to Do It? (Video)
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Laparoscopic sleeve gastrectomy is the most common bariatric procedure worldwide, commonly performed using laparoscopic multiport. Feasibility and safety of single-port sleeve gastrectomy (SPSG) have been proved. We reported a standardized procedure describing the different steps as a reference for bariatric surgeons.
Two news concepts are necessary: “surgical corridor,” surgeon working in a small intraperitoneal area is less disturbed by excess abdominal fat and liver hypertrophy; “parietal space” is the area in the abdominal wall through the instruments are introduced, it’s important to preserve this.
The patient was placed in a seated position and we utilized 2.5–3 cm skin incision in the umbilicus. Single trocar was placed; a flexible camera and double curve grasper are needed to decrease grasper conflict. Dissection of the stomach was obtained by 47 cm Thunderbeat (Olympus-Japan), the sleeve of the stomach was created over a 36F calibrator. A 60-mm roticulating XL staplers were used and beginning 4 cm proximal to the pylorus next to the gastro-pancreatic ligament and heading toward the left side of the gastro-esophageal junction. We utilized a linear staple line using 4 to 7 staples; hemostasis is controlled by bipolar coagulation.
Specimen was removed easily through the single-site trocar. Parietal defect is easily repaired. Operating time is 41 min. The patient was discharged at day 1 without naso-gastric tube or drainage. No complication.
Umbilical SPSG is nowadays a standardized procedure based on the surgical corridor and the parietal space. This is a safe and reproductive procedure applicable in most patients with massive obesity but necessitate learning curve.
KeywordsObesity Sleeve Single port Umbilicus Minimaly invasive surgery
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval Statement
This is a retrospective video: for this type of study, formal consent is not required in France.
Informed Consent Statement
Informed consent was obtained from the patient included in this video.
(MP4 123,720 kb)