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Weight-loss outcomes of SPIDER® sleeve gastrectomy at 6 months compared to traditional laparoscopic technique

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Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) has become a primary stand-alone procedure for weight-loss surgery. The standard technique for LSG involves several small abdominal incisions. The single port instrument delivery extended reach (SPIDER®) surgical system has been introduced as a single site modality. This technique has been described previously; however, weight-loss outcomes of SPIDER® sleeve gastrectomy have not been compared to multi-port LSG.

Methods

We performed a retrospective review of a prospectively collected database. All cases were performed by a single surgeon between August 2011 and September 2013. Thirty-two patients underwent SPIDER® sleeve gastrectomy, while 30 underwent LSG. Primary outcomes were change in BMI and percent excess weight loss (%EWL) at 6 months post-operatively. Secondary outcomes included: operative time, estimated blood loss (EBL), and complications.

Results

There were no demographic differences between cohorts except initial BMI (SPIDER® = 42.1, LSG = 46.5, p < 0.001). Mean %EWL at 6 months post-operatively was higher in the SPIDER® cohort (59.1 vs. 48.3 %, p < 0.005). Similarly there was a lower mean BMI at 6 months post-operatively in the SPIDER® cohort (31.1 vs. 35.5, p < 0.0001). The net change in BMI for each cohort was equivalent (SPIDER® = 11.1, LSG = 11.0, p = 0.95). Mean operative time was longer in SPIDER® cases (104.6 vs. 90.7 min, p < 0.02), while EBL was equivalent (32.1 vs. 34.3 mL, p = 0.56). There was one post-operative hemorrhage requiring laparoscopic clot evacuation in the SPIDER® cohort, and one wound infection in the LSG cohort.

Conclusions

SPIDER® sleeve gastrectomy is not inferior to LSG with regard to decrease in BMI and %EWL at 6-months post-operatively. The higher %EWL observed in the SPIDER® cohort is likely due to patient selection bias. This study demonstrates that the SPIDER® technique is a viable alternative to LSG with similar weight-loss outcomes.

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Acknowledgments

We wish to acknowledge Julia Bader, PhD, for her assistance with statistical analysis.

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Authors and Affiliations

  1. Department of Surgery, William Beaumont Army Medical Center, 5005 N. Piedras, ATTN: DOS, El Paso, TX, 79920, USA

    Kathryn B. Muir & William V. Rice

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  1. Kathryn B. Muir
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  2. William V. Rice
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Correspondence to Kathryn B. Muir.

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Disclosures

Drs. Kathryn B. Muir and William V. Rice have no conflicts of interest or financial ties to disclose.

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The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of Defense or the United States Government.

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Muir, K.B., Rice, W.V. Weight-loss outcomes of SPIDER® sleeve gastrectomy at 6 months compared to traditional laparoscopic technique. Surg Endosc 30, 2043–2048 (2016). https://doi.org/10.1007/s00464-015-4451-z

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  • DOI: https://doi.org/10.1007/s00464-015-4451-z

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