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Outcome Analysis of Single Incision vs Traditional Multiport Sleeve Gastrectomy: A Matched Cohort Study

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Abstract

Background

Single incision laparoscopy remains controversial due to technical challenges which may cause suboptimal outcomes. This study aims to evaluate the feasibility and equivalency of the single incision sleeve gastrectomy (SISG) when compared to the traditional multiport sleeve gastrectomy (MPSG) approach in a matched cohort evaluating technical aspects and postoperative results.

Methods

This is a retrospective analysis of prospectively collected data in a consecutive cohort of 113 SG (MPSG = 77, SISG = 36). The 36 patients who underwent SISG were included as the case group. Thirty-six MPSG patients were included in the control group, in 1:1 ratio with cases after matching for BMI, age, race, gender, and additional demographic data. Operative time (OT) in minutes and length of stay (LOS) in days was measured and excess weight loss (EWL) at 6 months and 1 year was collected and evaluated.

Results

Mean BMI was equivalent (SISG 43.06, MPSG 43.72, p = 0.36). Mean OT for the SISG was 116.78 and 118.25 for the MPSG (p = 0.84), and mean LOS was 1.80 for the SISG and 1.75 for the MSPG (p = 0.75). EWL at 6 months was 58.4 % for the SISG and 58.5 % for the MPSG (p = 0.98) and 72.3 and 74.1 % (p = 0.77) for 1 year, respectively. There were no leaks in either group. There was one reoperation for postoperative bleeding in the MPSG group.

Conclusions

Sleeve gastrectomy can be performed safely using single incision techniques with equivalent outcomes for weight loss.

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References

  1. Wheeless Jr CR. Elimination of second incision in laparoscopic sterilization. Obstet Gynecol. 1972;39(1):134–6.

    PubMed  Google Scholar 

  2. Alevizos L, Lirici MM. Laparo-endoscopic single-site sleeve gastrectomy: results from a preliminary series of selected patients. Minim Invasive Ther Allied Technol. 2012;21(1):40–5. doi:10.3109/13645706.2011.651474.

    Article  PubMed  Google Scholar 

  3. Zhang F, Strain GW, Lei W, et al. Changes in lipid profiles in morbidly obese patients after laparoscopic sleeve gastrectomy (LSG). Obes Surg. 2011;21(3):305–9. doi:10.1007/s11695-010-0285-x.

    Article  PubMed  Google Scholar 

  4. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37. doi:10.1001/jama.292.14.1724.

    Article  PubMed  CAS  Google Scholar 

  5. Nguyen NT, Nguyen B, Gebhart A, et al. Changes in the makeup of bariatric surgery: a national increase in use of laparoscopic sleeve gastrectomy. J Am Coll Surg. 2013;216(2):252–7. doi:10.1016/j.jamcollsurg.2012.10.003.

    Article  PubMed  Google Scholar 

  6. Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20(6):859–63. doi:10.1007/s00464-005-0134-5.

    Article  PubMed  CAS  Google Scholar 

  7. Saber AA, Elgamal MH, Itawi EA, et al. Single incision laparoscopic sleeve gastrectomy (SILS): a novel technique. Obes Surg. 2008;18(10):1338–42. doi:10.1007/s11695-008-9646-0.

    Article  PubMed  Google Scholar 

  8. Huang CK. Single-incision laparoscopic bariatric surgery. J Minim Access Surg. 2011;7(1):99–103. doi:10.4103/0972-9941.72397.

    PubMed  PubMed Central  Google Scholar 

  9. Batchelder AJ, Williams R, Sutton C, et al. The evolution of minimally invasive bariatric surgery. J Surg Res. 2013;183(2):559–66. doi:10.1016/j.jss.2013.02.036.

    Article  PubMed  Google Scholar 

  10. Lakdawala MA, Muda NH, Goel S, et al. Single-incision sleeve gastrectomy versus conventional laparoscopic sleeve gastrectomy—a randomised pilot study. Obes Surg. 2011;21(11):1664–70. doi:10.1007/s11695-011-0478-y.

    Article  PubMed  Google Scholar 

  11. Delgado S, Ibarzabal A, Adelsdorfer C, et al. Transumbilical single-port sleeve gastrectomy: initial experience and comparative study. Surg Endosc. 2012;26(5):1247–53. doi:10.1007/s00464-011-2002-9.

    Article  PubMed  Google Scholar 

  12. Shi X, Karmali S, Sharma AM, et al. A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010;20(8):1171–7. doi:10.1007/s11695-010-0145-8.

    Article  PubMed  Google Scholar 

  13. Gentileschi P, Camperchioli I, Benavoli D, et al. Laparoscopic single-port sleeve gastrectomy for morbid obesity: preliminary series. Surg Obes Relat Dis. 2010;6(6):665–9. doi:10.1016/j.soard.2010.01.011.

    Article  PubMed  Google Scholar 

  14. Marks JM, Phillips MS, Tacchino R, et al. Single-incision laparoscopic cholecystectomy is associated with improved cosmesis scoring at the cost of significantly higher hernia rates: 1-year results of a prospective randomized, multicenter, single-blinded trial of traditional multiport laparoscopic cholecystectomy vs single-incision laparoscopic cholecystectomy. J Am Coll Surg. 2013;216(6):1037–47. doi:10.1016/j.jamcollsurg.2013.02.024. discussion 1047-1038.

    Article  PubMed  Google Scholar 

  15. Sysko R, Devlin MJ, Hildebrandt TB, et al. Psychological outcomes and predictors of initial weight loss outcomes among severely obese adolescents receiving laparoscopic adjustable gastric banding. J Clin Psychiatry. 2012;73(10):1351–7. doi:10.4088/JCP.12m07690.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Nagayasu S, Suzuki S, Yamashita A, et al. Smoking and adipose tissue inflammation suppress leptin expression in Japanese obese males: potential mechanism of resistance to weight loss among Japanese obese smokers. Tob Induc Dis. 2012;10:3. doi:10.1186/1617-9625-10-3.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  17. Lutfi R, Torquati A, Sekhar N, et al. Predictors of success after laparoscopic gastric bypass: a multivariate analysis of socioeconomic factors. Surg Endosc. 2006;20(6):864–7. doi:10.1007/s00464-005-0115-8.

    Article  PubMed  CAS  Google Scholar 

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Disclosures

Dr. Lutfi reports other from Ethicon Endo Surgery, other from GORE outside the submitted work. Drs. Gomberawalla and Salamat have no conflicts of interest or financial ties to disclose.

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Correspondence to Ameer Gomberawalla.

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Gomberawalla, A., Salamat, A. & Lutfi, R. Outcome Analysis of Single Incision vs Traditional Multiport Sleeve Gastrectomy: A Matched Cohort Study. OBES SURG 24, 1870–1874 (2014). https://doi.org/10.1007/s11695-014-1312-0

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