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Published in: Obesity Surgery 3/2017

01-03-2017 | Original Contributions

Prospective Comparison and Quality of Life for Single-Incision and Conventional Laparoscopic Sleeve Gastrectomy in a Series of Morbidly Obese Patients

Authors: Andrea Porta, Alberto Aiolfi, Cinzia Musolino, Ilaria Antonini, Marco Antonio Zappa

Published in: Obesity Surgery | Issue 3/2017

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Abstract

Background

Laparoscopic sleeve gastrectomy has gained a wide acceptance in the surgical community with an increasing popularity in the field of bariatric surgery. Simultaneously more surgeons have become acquainted with the single port techniques and sleeve gastrectomy has been regarded as an ideal field of application. Literature is scarce about operative and clinical outcomes of single port sleeve gastrectomy compared to conventional laparoscopy. The primary purpose of the study was to compare operative outcomes in the two study groups. Assessment and comparison of functional outcomes in terms of quality of life between groups was also performed.

Methods

Prospective data on 130 consecutive patients who underwent randomized SI or CL sleeve gastrectomy were collected between January 2009 to December 2014. Preoperative parameters, outcomes, post-operative functional results and quality of life, according to the short-form SF-36 questionnaire, were evaluated and compared between groups.

Results

65 patients underwent conventional laparoscopic (CL) and 65 single incision (SI) sleeve gastrectomy. Operative time, post-operative pain, in-hospital stay, and complications were similar in the two groups. No difference emerged with respect to passage of flatus and resumption of oral intake (p = NS). Cosmetic results were excellent in SI patients with higher satisfaction rates. Post-operative quality of life was significant higher compared to baseline (p < 0.05), and comparable between the two procedures.

Conclusions

Single incision sleeve gastrectomy is safe, effective and comparable to the conventional laparoscopic technique in terms of outcomes. Post-operative quality of life is comparable between the two procedures.
Literature
1.
go back to reference Cottam D, Qureshi FD, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.CrossRefPubMed Cottam D, Qureshi FD, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.CrossRefPubMed
2.
go back to reference Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.CrossRefPubMed Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.CrossRefPubMed
3.
go back to reference Sammour T, Hill AG, Singh P, Ranasinghe A, Babor R, Rahman H. Laparoscopic sleeve gastrectomy as a single-stage bariatric procedure. Obes Surg. 2010;20:271–5.CrossRefPubMed Sammour T, Hill AG, Singh P, Ranasinghe A, Babor R, Rahman H. Laparoscopic sleeve gastrectomy as a single-stage bariatric procedure. Obes Surg. 2010;20:271–5.CrossRefPubMed
4.
go back to reference Boza C, Salinas J, Salgado N, Pérez G, Raddatz A, Funke R, Pimentel F, Ibáñez L. Laparoscopic sleeve gastrectomy as a stand-alone procedure for morbid obesity: report of 1,000 cases and 3-year follow-up. Obes Surg. 2012;22:866–71.CrossRefPubMed Boza C, Salinas J, Salgado N, Pérez G, Raddatz A, Funke R, Pimentel F, Ibáñez L. Laparoscopic sleeve gastrectomy as a stand-alone procedure for morbid obesity: report of 1,000 cases and 3-year follow-up. Obes Surg. 2012;22:866–71.CrossRefPubMed
5.
go back to reference Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.CrossRefPubMed Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.CrossRefPubMed
6.
go back to reference Vidal P, Ramón JM, Goday A, Benaiges D, Trillo L, Parri A, González S, Pera M, Grande L. Laparoscopic gastric bypass versus laparoscopic sleeve gastrectomy as a definitive surgical procedure for morbid obesity. Mid-Term Results Obes Surg. 2013;23:292–9.CrossRefPubMed Vidal P, Ramón JM, Goday A, Benaiges D, Trillo L, Parri A, González S, Pera M, Grande L. Laparoscopic gastric bypass versus laparoscopic sleeve gastrectomy as a definitive surgical procedure for morbid obesity. Mid-Term Results Obes Surg. 2013;23:292–9.CrossRefPubMed
7.
go back to reference Deytel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18:487–96.CrossRef Deytel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18:487–96.CrossRef
8.
go back to reference Hunag CK, Tsai JC, Lo CH, Houng JY, Chen YS, Chi SC, Lee PH. Preliminary surgical results of single-incision transumbilical laparoscopic bariatric surgery. Obes Surg. 2011;21:391–6.CrossRef Hunag CK, Tsai JC, Lo CH, Houng JY, Chen YS, Chi SC, Lee PH. Preliminary surgical results of single-incision transumbilical laparoscopic bariatric surgery. Obes Surg. 2011;21:391–6.CrossRef
10.
go back to reference Reavis KM, Hinojosa MV, Smith BR, Nguyen NT. Single-laparoscopic incision transabdominal surgery sleeve gastrectomy. Obes Surg. 2008;18:1492–4.CrossRefPubMed Reavis KM, Hinojosa MV, Smith BR, Nguyen NT. Single-laparoscopic incision transabdominal surgery sleeve gastrectomy. Obes Surg. 2008;18:1492–4.CrossRefPubMed
11.
go back to reference Saber AA, Elgamal MH, Itawi EA, et al. Single incision laparoscopic sleeve gastrectomy (SILS): a novel technique. Obes Surg. 2008;18:1338–42.CrossRefPubMed Saber AA, Elgamal MH, Itawi EA, et al. Single incision laparoscopic sleeve gastrectomy (SILS): a novel technique. Obes Surg. 2008;18:1338–42.CrossRefPubMed
12.
go back to reference Gentileschi P, Camperchioli I, Benavoli D, Di Lorenzo N, Sica G, Gaspari AL. Laparoscopic single-port sleeve gastrectomy for morbid obesity: preliminary series. Surg Obes Relat Dis. 2010;6:665–9.CrossRefPubMed Gentileschi P, Camperchioli I, Benavoli D, Di Lorenzo N, Sica G, Gaspari AL. Laparoscopic single-port sleeve gastrectomy for morbid obesity: preliminary series. Surg Obes Relat Dis. 2010;6:665–9.CrossRefPubMed
13.
go back to reference Farìas C, Fernandez JI, Ovalle C, Cabrera C, De la Maza J, Kosiel K, Molina AM. Transumbilical sleeve gastrectomy with an accessory lateral port: surgical results in 237 patients and 1-year follow-up. Obes Surg. 2013;23:325–31.CrossRefPubMed Farìas C, Fernandez JI, Ovalle C, Cabrera C, De la Maza J, Kosiel K, Molina AM. Transumbilical sleeve gastrectomy with an accessory lateral port: surgical results in 237 patients and 1-year follow-up. Obes Surg. 2013;23:325–31.CrossRefPubMed
14.
go back to reference Lo C, Latin L, Fariñas Á, Cruz Pico CX, Postoev A, Ibikunle C, Sanni A. Does single-port laparoscopic sleeve gastrectomy result in improved short-term perioperative outcomes compared to conventional multi-port laparoscopic sleeve gastrectomy? Int J Surg. 2015;22:67–71.CrossRefPubMed Lo C, Latin L, Fariñas Á, Cruz Pico CX, Postoev A, Ibikunle C, Sanni A. Does single-port laparoscopic sleeve gastrectomy result in improved short-term perioperative outcomes compared to conventional multi-port laparoscopic sleeve gastrectomy? Int J Surg. 2015;22:67–71.CrossRefPubMed
15.
go back to reference Yee J, Koshiver J, Allbon C, Brown C. Comparison of intramuscular ketorolac tromethamine and morphine sulfate for analgesia of pain after major surgery. Pharmacotherapy. 1986;6:253–61.CrossRefPubMed Yee J, Koshiver J, Allbon C, Brown C. Comparison of intramuscular ketorolac tromethamine and morphine sulfate for analgesia of pain after major surgery. Pharmacotherapy. 1986;6:253–61.CrossRefPubMed
16.
go back to reference O’Hara D, Fragen R, Kinzer M, Pemberton D. Ketorolac tromethamine as compared with morphine sulfate for treatment of postoperative pain. Clin Pharmacol Ther. 1987;41:556–61.CrossRefPubMed O’Hara D, Fragen R, Kinzer M, Pemberton D. Ketorolac tromethamine as compared with morphine sulfate for treatment of postoperative pain. Clin Pharmacol Ther. 1987;41:556–61.CrossRefPubMed
17.
go back to reference Gordon DB, Stevenson KK, Griffie J, Muchka S, Rapp C, Ford-Roberts K. Opioid equianalgesic calculations. J Palliat Med. 1999;2:209–18.CrossRefPubMed Gordon DB, Stevenson KK, Griffie J, Muchka S, Rapp C, Ford-Roberts K. Opioid equianalgesic calculations. J Palliat Med. 1999;2:209–18.CrossRefPubMed
18.
go back to reference Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral
19.
go back to reference Apolone G, Mosconi P. The Italian SF-36 health survey: translation, validation and norming. J Clin Epidemiol. 1998;51:1025–36.CrossRefPubMed Apolone G, Mosconi P. The Italian SF-36 health survey: translation, validation and norming. J Clin Epidemiol. 1998;51:1025–36.CrossRefPubMed
20.
go back to reference Ware JE, Snow KK, Kosinski M. SF36 health survey. Manual and interpretation guide. Boston: New England Medical Centre, The Health Institute; 1993. Ware JE, Snow KK, Kosinski M. SF36 health survey. Manual and interpretation guide. Boston: New England Medical Centre, The Health Institute; 1993.
21.
go back to reference Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg. 2001;234:279–89.CrossRefPubMedPubMedCentral Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg. 2001;234:279–89.CrossRefPubMedPubMedCentral
22.
go back to reference Weller W, Rosati C. Comparing outcomes of laparoscopic versus open bariatric surgery. Ann Surg. 2008;248:10–5.CrossRefPubMed Weller W, Rosati C. Comparing outcomes of laparoscopic versus open bariatric surgery. Ann Surg. 2008;248:10–5.CrossRefPubMed
23.
go back to reference Saber AA, El-Ghazaly TH, Dewoolkar AV, Slayton SA. Single-incision laparoscopic sleeve gastrectomy versus conventional multiport laparoscopic sleeve gastrectomy: technical considerations and strategic modifications. Surg Obes Relat Dis. 2010;658–664. Saber AA, El-Ghazaly TH, Dewoolkar AV, Slayton SA. Single-incision laparoscopic sleeve gastrectomy versus conventional multiport laparoscopic sleeve gastrectomy: technical considerations and strategic modifications. Surg Obes Relat Dis. 2010;658–664.
24.
go back to reference Gomberawalla A, Salamat A, Lutfi R. Outcome analysis of single incision vs traditional multiport sleeve gastrectomy: a matched cohort study. Obes Surg. 2014;24:1870–4.CrossRefPubMed Gomberawalla A, Salamat A, Lutfi R. Outcome analysis of single incision vs traditional multiport sleeve gastrectomy: a matched cohort study. Obes Surg. 2014;24:1870–4.CrossRefPubMed
25.
go back to reference Delgado S, Ibarzabal A, Adelsdorfer C, Adelsdorfer W, Corcelles R, Momblan D, Lacy AM. Transumbilical single-port sleeve gastrectomy: initial experience and comparative study. Surg Endosc. 2012;26:1247–53.CrossRefPubMed Delgado S, Ibarzabal A, Adelsdorfer C, Adelsdorfer W, Corcelles R, Momblan D, Lacy AM. Transumbilical single-port sleeve gastrectomy: initial experience and comparative study. Surg Endosc. 2012;26:1247–53.CrossRefPubMed
26.
go back to reference Lakdawala M, Agarwal A, Dhar S, Dhulla N, Remedios C, Bhasker AG. Single-incision sleeve gastrectomy versus laparoscopic sleeve gastrectomy. A 2-year comparative analysis of 600 patients. Obes Surg. 2015;25:607–14.CrossRefPubMed Lakdawala M, Agarwal A, Dhar S, Dhulla N, Remedios C, Bhasker AG. Single-incision sleeve gastrectomy versus laparoscopic sleeve gastrectomy. A 2-year comparative analysis of 600 patients. Obes Surg. 2015;25:607–14.CrossRefPubMed
27.
go back to reference Sucher R, Resch T, Mohr E, Perathoner A, Biebl M, Pratschke J, Mittermair R. Single-incision laparoscopic sleeve gastrectomy versus multiport laparoscopic sleeve gastrectomy: analysis of 80 cases in a single center. J Laparoendosc Adv Surg Tech A. 2014;24:83–8.CrossRefPubMed Sucher R, Resch T, Mohr E, Perathoner A, Biebl M, Pratschke J, Mittermair R. Single-incision laparoscopic sleeve gastrectomy versus multiport laparoscopic sleeve gastrectomy: analysis of 80 cases in a single center. J Laparoendosc Adv Surg Tech A. 2014;24:83–8.CrossRefPubMed
28.
go back to reference Sajid MS, Ladwa N, Kalra L, Hutson KK, Singh KK, Sayegh M. Single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: meta-analysis and systematic review of randomized controlled trials. World J Surg. 2012;36:2644–53.CrossRefPubMed Sajid MS, Ladwa N, Kalra L, Hutson KK, Singh KK, Sayegh M. Single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: meta-analysis and systematic review of randomized controlled trials. World J Surg. 2012;36:2644–53.CrossRefPubMed
29.
go back to reference St Peter SD, Adibe OO, Juang D, Sharp SW, Garey CL, Laituri CA, et al. Single incision versus standard 3-port laparoscopic appendectomy: a prospective randomized trial. Ann Surg. 2011;254:586–90.CrossRefPubMed St Peter SD, Adibe OO, Juang D, Sharp SW, Garey CL, Laituri CA, et al. Single incision versus standard 3-port laparoscopic appendectomy: a prospective randomized trial. Ann Surg. 2011;254:586–90.CrossRefPubMed
30.
go back to reference Choi ST, Lee JN, Kim KK, Park YH, Lee WK, Baek JH, Lee TH. Single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy: a prospective randomized controlled study. Ann Surg. 2013;257:214–8.CrossRefPubMed Choi ST, Lee JN, Kim KK, Park YH, Lee WK, Baek JH, Lee TH. Single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy: a prospective randomized controlled study. Ann Surg. 2013;257:214–8.CrossRefPubMed
Metadata
Title
Prospective Comparison and Quality of Life for Single-Incision and Conventional Laparoscopic Sleeve Gastrectomy in a Series of Morbidly Obese Patients
Authors
Andrea Porta
Alberto Aiolfi
Cinzia Musolino
Ilaria Antonini
Marco Antonio Zappa
Publication date
01-03-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 3/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2338-2

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