9. Single-Site Access Bariatric Surgery: Principles and Techniques

Abstract

Laparoendoscopic single-site (LESS) surgery is not a new concept and its recent resurgence is a consequence of natural orifice transluminal endoscopic surgery research. Potential benefits of less pain, faster recovery, and improved cosmesis have been difficult to demonstrate conclusively. In bariatric procedures, the single incision approach maximizes the use of larger incisions needed to extract a specimen or implant a device. The bariatric patient is particularly sensitive to the body image benefit LESS can offer because the decreased scarring facilitates the ability to maintain bariatric surgery as a discreet affair. This chapter discusses patient selection, contraindications, instrumentation, techniques, and strategies to overcome the challenges posed by single-incision surgery. The main emphasis is the application of these concepts to the single-incision-adjustable gastric band and vertical sleeve gastrectomy.