Abstract
Background
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.
Materials
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.
Results
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.
Conclusion
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.
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References
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This is a retrospective video: for this type of study, formal consent is not required in France.
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Informed consent was obtained from the patient included in this video.
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Fadhl, H., Suhool, A., Donatelli, G. et al. Umbilical Single-Port Sleeve Gastrectomy as a Standardized Procedure: How to Do It? (Video). OBES SURG 29, 1697–1698 (2019). https://doi.org/10.1007/s11695-019-03728-4
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DOI: https://doi.org/10.1007/s11695-019-03728-4