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Laparoscopic single-incision gastric bypass: initial experience, technique and short-term outcomes

BACKGROUND: Single incision laparoscopic surgery (SILS) research has been limited. The aim of this study is to describe our technique and to evaluate the short term outcomes and efficacy of SILS Roux-en-Y gastric bypass (RYGB) in a selected group of patients in a single center. METHODS: From March 2...

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Autores principales: Zepeda Mejia, Ivan Alberto, Rogula, Tomasz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606897/
https://www.ncbi.nlm.nih.gov/pubmed/26473005
http://dx.doi.org/10.1186/s13022-015-0016-z
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author Zepeda Mejia, Ivan Alberto
Rogula, Tomasz
author_facet Zepeda Mejia, Ivan Alberto
Rogula, Tomasz
author_sort Zepeda Mejia, Ivan Alberto
collection PubMed
description BACKGROUND: Single incision laparoscopic surgery (SILS) research has been limited. The aim of this study is to describe our technique and to evaluate the short term outcomes and efficacy of SILS Roux-en-Y gastric bypass (RYGB) in a selected group of patients in a single center. METHODS: From March 2012 to January 2013, a total of fourteen patients underwent SILS RYGB using a single vertical 2.5–3 cm intra-umbilical incision, 3-ports placed trans-fascially, and a liver suspension technique in Cleveland Clinic’s Bariatric & Metabolic Institute, in Cleveland, Ohio, USA. Patient selection, short-term outcomes and technical issues were retrospectively viewed in this study. RESULTS: A total of 14 morbid obese patients (12 women and 2 men; mean age, 46 years). Mean operative time was 196 (range 131–265) min. Mean weight at surgery was 113 (range 91–135) kg. One patient required placement of one additional port (7 %). No conversions to conventional laparoscopic surgery (CLS) or open surgery was needed. The estimated blood loss was 40 (range 20–100) ml. In terms of pain control, the frequency of patient controlled analgesia had a mean use of 21 times in postoperative day 0 (POD), 37 times in POD1 and 13 times in POD2. Pain score (assessed by visual analogue scale) had a median score of 6.9 in POD0, 5.2 In POD1 and 3.8 in POD2. Weight loss was approximately 7.25 lb. (±4.5) after first postoperative visit, 28.9 lb. (±11.86) after 1 month and 45.4 lb. (±15.4) after 4 months. No patients required re-operation or readmission during the 90 days after surgery. CONCLUSION: Single incision is feasible, safe and reproducible technique used as an access to complex surgeries like gastric bypass in carefully selected patients. Results in short-term outcomes are comparable to those observed in literature. Some potential benefits include less postoperative pain, improved cosmesis, and patient satisfaction. Randomized trials involving larger patient series with a longer follow-up and larger cohort studies and/or systematic reviews will be necessary to assess the extent of the benefits and limitations of SILS in bariatric surgery.
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spelling pubmed-46068972015-10-16 Laparoscopic single-incision gastric bypass: initial experience, technique and short-term outcomes Zepeda Mejia, Ivan Alberto Rogula, Tomasz Ann Surg Innov Res Review BACKGROUND: Single incision laparoscopic surgery (SILS) research has been limited. The aim of this study is to describe our technique and to evaluate the short term outcomes and efficacy of SILS Roux-en-Y gastric bypass (RYGB) in a selected group of patients in a single center. METHODS: From March 2012 to January 2013, a total of fourteen patients underwent SILS RYGB using a single vertical 2.5–3 cm intra-umbilical incision, 3-ports placed trans-fascially, and a liver suspension technique in Cleveland Clinic’s Bariatric & Metabolic Institute, in Cleveland, Ohio, USA. Patient selection, short-term outcomes and technical issues were retrospectively viewed in this study. RESULTS: A total of 14 morbid obese patients (12 women and 2 men; mean age, 46 years). Mean operative time was 196 (range 131–265) min. Mean weight at surgery was 113 (range 91–135) kg. One patient required placement of one additional port (7 %). No conversions to conventional laparoscopic surgery (CLS) or open surgery was needed. The estimated blood loss was 40 (range 20–100) ml. In terms of pain control, the frequency of patient controlled analgesia had a mean use of 21 times in postoperative day 0 (POD), 37 times in POD1 and 13 times in POD2. Pain score (assessed by visual analogue scale) had a median score of 6.9 in POD0, 5.2 In POD1 and 3.8 in POD2. Weight loss was approximately 7.25 lb. (±4.5) after first postoperative visit, 28.9 lb. (±11.86) after 1 month and 45.4 lb. (±15.4) after 4 months. No patients required re-operation or readmission during the 90 days after surgery. CONCLUSION: Single incision is feasible, safe and reproducible technique used as an access to complex surgeries like gastric bypass in carefully selected patients. Results in short-term outcomes are comparable to those observed in literature. Some potential benefits include less postoperative pain, improved cosmesis, and patient satisfaction. Randomized trials involving larger patient series with a longer follow-up and larger cohort studies and/or systematic reviews will be necessary to assess the extent of the benefits and limitations of SILS in bariatric surgery. BioMed Central 2015-10-15 /pmc/articles/PMC4606897/ /pubmed/26473005 http://dx.doi.org/10.1186/s13022-015-0016-z Text en © Zepeda Mejia and Rogula. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Zepeda Mejia, Ivan Alberto
Rogula, Tomasz
Laparoscopic single-incision gastric bypass: initial experience, technique and short-term outcomes
title Laparoscopic single-incision gastric bypass: initial experience, technique and short-term outcomes
title_full Laparoscopic single-incision gastric bypass: initial experience, technique and short-term outcomes
title_fullStr Laparoscopic single-incision gastric bypass: initial experience, technique and short-term outcomes
title_full_unstemmed Laparoscopic single-incision gastric bypass: initial experience, technique and short-term outcomes
title_short Laparoscopic single-incision gastric bypass: initial experience, technique and short-term outcomes
title_sort laparoscopic single-incision gastric bypass: initial experience, technique and short-term outcomes
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606897/
https://www.ncbi.nlm.nih.gov/pubmed/26473005
http://dx.doi.org/10.1186/s13022-015-0016-z
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