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Published in: Obesity Surgery 10/2019

01-10-2019 | Sleeve Gastrectomy | Original Contributions

Reduced-Port Sleeve Gastrectomy for Morbidly Obese Japanese Patients: a Retrospective Case-Matched Study

Authors: Manabu Amiki, Yosuke Seki, Kazunori Kasama, Srinivasulu Pachimatla, Michiko Kitagawa, Akiko Umezawa, Yoshimochi Kurokawa

Published in: Obesity Surgery | Issue 10/2019

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Abstract

Background

Reduced-port laparoscopic surgery remains controversial due to technical challenges that can lead to suboptimal outcomes, and data pertaining to operative and clinical outcomes of reduced-port sleeve gastrectomy (RPSG) vs. conventional laparoscopic sleeve gastrectomy (CLSG) are lacking.

Aims

This retrospective case-matched study aimed to compare midterm (2-year) outcomes of RPSG and of CLSG.

Methods

Patients included in the study had undergone laparoscopic bariatric surgery at our center between 2010 and 2017. Thirty-one consecutive female patients who underwent RPSG were compared to a sex-, age-, body mass index–matched group of 31 patients who underwent CLSG. Outcomes were evaluated and compared between groups.

Results

Estimated blood loss volume, incidences of intraoperative and postoperative complications, and length of postoperative hospital stay did not differ significantly between the 2 groups. Operation time was significantly greater in the RPSG group than in the CLSG group (148.7 ± 22.6 vs. 120.2 ± 25.9 min, respectively; p < 0.001). Excess weight loss at 1 year was 105.9% and 109.7%, respectively (p = 0.94) and at 2 years was 101.1% and 105.3%, respectively (p = 0.64). One RPSG patient required placement of additional trocars because of bleeding from short gastric vessels, but conversion to open surgery was not required.

Conclusions

RPSG is feasible in carefully selected bariatric patients and results in midterm outcomes comparable to those observed after CLSG. Good cosmesis is a potential benefit of RPSG.
Literature
1.
go back to reference Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.CrossRef Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.CrossRef
2.
go back to reference Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery and endoluminal procedures: IFSO worldwide survey 2014. Obes Surg. 2017;27:2279–89.CrossRef Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery and endoluminal procedures: IFSO worldwide survey 2014. Obes Surg. 2017;27:2279–89.CrossRef
3.
go back to reference Ohta M, Seki Y, Wong SK, Wang C, Huang CK, Aly A, et al. Bariatric/metabolic surgery in the Asia-Pacific region: APMBSS 2018 survey. Obes Surg. Springer; 2018;1–8. Ohta M, Seki Y, Wong SK, Wang C, Huang CK, Aly A, et al. Bariatric/metabolic surgery in the Asia-Pacific region: APMBSS 2018 survey. Obes Surg. Springer; 2018;1–8.
4.
go back to reference Lee WS, Choi ST, Lee JN, et al. Single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy: a prospective randomized controlled study. Ann Surg. 2013;257:214–8.CrossRef Lee WS, Choi ST, Lee JN, et al. Single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy: a prospective randomized controlled study. Ann Surg. 2013;257:214–8.CrossRef
5.
go back to reference Curcillo PG, Wu AS, Podolsky ER, et al. Single-port-access (SPA TM) cholecystectomy: a multi-institutional report of the first 297 cases. Surg Endosc. 2010;24:1854–60.CrossRef Curcillo PG, Wu AS, Podolsky ER, et al. Single-port-access (SPA TM) cholecystectomy: a multi-institutional report of the first 297 cases. Surg Endosc. 2010;24:1854–60.CrossRef
6.
go back to reference Champagne BJ, Papaconstantinou HT, Parmar SS, et al. Single-incision versus standard multiport laparoscopic colectomy: a multicenter, case-controlled comparison. Ann Surg LWW. 2012;255:66–9.CrossRef Champagne BJ, Papaconstantinou HT, Parmar SS, et al. Single-incision versus standard multiport laparoscopic colectomy: a multicenter, case-controlled comparison. Ann Surg LWW. 2012;255:66–9.CrossRef
7.
go back to reference Raman JD, Bagrodia A, Cadeddu JA. Single-incision, umbilical laparoscopic versus conventional laparoscopic nephrectomy: a comparison of perioperative outcomes and short-term measures of convalescence. Eur Urol. 2009;55:1198–206.CrossRef Raman JD, Bagrodia A, Cadeddu JA. Single-incision, umbilical laparoscopic versus conventional laparoscopic nephrectomy: a comparison of perioperative outcomes and short-term measures of convalescence. Eur Urol. 2009;55:1198–206.CrossRef
8.
go back to reference Targarona EM, Balague C, Martinez C, et al. Single-port access: a feasible alternative to conventional laparoscopic splenectomy. Surg Innov. 2009;16:348–52.CrossRef Targarona EM, Balague C, Martinez C, et al. Single-port access: a feasible alternative to conventional laparoscopic splenectomy. Surg Innov. 2009;16:348–52.CrossRef
9.
go back to reference Hamzaoglu I, Karahasanoglu T, Aytac E, et al. Transumbilical totally laparoscopic single-port Nissen fundoplication: a new method of liver retraction: the Istanbul technique. J Gastrointest Surg. 2010;14:1035–9.CrossRef Hamzaoglu I, Karahasanoglu T, Aytac E, et al. Transumbilical totally laparoscopic single-port Nissen fundoplication: a new method of liver retraction: the Istanbul technique. J Gastrointest Surg. 2010;14:1035–9.CrossRef
10.
go back to reference Saber AA, El-Ghazaly TH, Dewoolkar AV, et al. Single-incision laparoscopic sleeve gastrectomy versus conventional multiport laparoscopic sleeve gastrectomy: technical considerations and strategic modifications. Surg Obes Relat Dis. 2010;6:658–64.CrossRef Saber AA, El-Ghazaly TH, Dewoolkar AV, et al. Single-incision laparoscopic sleeve gastrectomy versus conventional multiport laparoscopic sleeve gastrectomy: technical considerations and strategic modifications. Surg Obes Relat Dis. 2010;6:658–64.CrossRef
11.
go back to reference Lakdawala M, Agarwal A, Dhar S, et al. Single-incision sleeve gastrectomy versus laparoscopic sleeve gastrectomy. A 2-year comparative analysis of 600 patients. Obes Surg. 2015;25:607–14.CrossRef Lakdawala M, Agarwal A, Dhar S, et al. Single-incision sleeve gastrectomy versus laparoscopic sleeve gastrectomy. A 2-year comparative analysis of 600 patients. Obes Surg. 2015;25:607–14.CrossRef
12.
go back to reference Delgado S, Ibarzabal A, Adelsdorfer C, et al. Transumbilical single-port sleeve gastrectomy: initial experience and comparative study. Surg Endosc. 2012;26:1247–53.CrossRef Delgado S, Ibarzabal A, Adelsdorfer C, et al. Transumbilical single-port sleeve gastrectomy: initial experience and comparative study. Surg Endosc. 2012;26:1247–53.CrossRef
13.
go back to reference Sucher R, Resch T, Mohr E, et al. Single-incision laparoscopic sleeve gastrectomy versus multiport laparoscopic sleeve gastrectomy: analysis of 80 cases in a single center. J Laparoendosc Adv Surg Tech. 2014;24:83–8.CrossRef Sucher R, Resch T, Mohr E, et al. Single-incision laparoscopic sleeve gastrectomy versus multiport laparoscopic sleeve gastrectomy: analysis of 80 cases in a single center. J Laparoendosc Adv Surg Tech. 2014;24:83–8.CrossRef
14.
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 Springer;. 2014;24:1870–4.CrossRef Gomberawalla A, Salamat A, Lutfi R. Outcome analysis of single incision vs traditional multiport sleeve gastrectomy: a matched cohort study. Obes Surg Springer;. 2014;24:1870–4.CrossRef
15.
go back to reference Porta A, Aiolfi A, Musolino C, et al. Prospective comparison and quality of life for single-incision and conventional laparoscopic sleeve gastrectomy in a series of morbidly obese patients. Obes Surg. Springer;. 2017;27:681–7.CrossRef Porta A, Aiolfi A, Musolino C, et al. Prospective comparison and quality of life for single-incision and conventional laparoscopic sleeve gastrectomy in a series of morbidly obese patients. Obes Surg. Springer;. 2017;27:681–7.CrossRef
16.
go back to reference Hosseini SV, Hosseini SA, Al-Hurry AMAH, et al. Comparison of early results and complications between multi-and single-port sleeve gastrectomy: a randomized clinical study. Iran J Med Sci. 2017;42:251.PubMedPubMedCentral Hosseini SV, Hosseini SA, Al-Hurry AMAH, et al. Comparison of early results and complications between multi-and single-port sleeve gastrectomy: a randomized clinical study. Iran J Med Sci. 2017;42:251.PubMedPubMedCentral
17.
go back to reference Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252:319–24.CrossRef Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252:319–24.CrossRef
19.
go back to reference Zachariah SK, Tai CM, Chang PC, et al. The “T-suspension tape” for liver and gallbladder retraction in bariatric surgery: feasibility, technique, and initial experience. J Laparoendosc Adv Surg Tech A. 2013;23:311–5.CrossRef Zachariah SK, Tai CM, Chang PC, et al. The “T-suspension tape” for liver and gallbladder retraction in bariatric surgery: feasibility, technique, and initial experience. J Laparoendosc Adv Surg Tech A. 2013;23:311–5.CrossRef
20.
go back to reference Mittermair R, Pratschke J, Sucher R. Single-incision laparoscopic sleeve gastrectomy. Am Surg. 2013;79:393–7.PubMed Mittermair R, Pratschke J, Sucher R. Single-incision laparoscopic sleeve gastrectomy. Am Surg. 2013;79:393–7.PubMed
21.
go back to reference Fernández JI, Ovalle C, Farias C, et al. Transumbilical laparoscopic Roux-en-Y gastric bypass with hand-sewn gastrojejunal anastomosis. Obes Surg. 2013;23:140–4.CrossRef Fernández JI, Ovalle C, Farias C, et al. Transumbilical laparoscopic Roux-en-Y gastric bypass with hand-sewn gastrojejunal anastomosis. Obes Surg. 2013;23:140–4.CrossRef
22.
go back to reference Palanivelu P, Patil KP, Parthasarathi R, et al. Review of various liver retraction techniques in single incision laparoscopic surgery for the exposure of hiatus. J Minim Access Surg. 2015;11:198–202.CrossRef Palanivelu P, Patil KP, Parthasarathi R, et al. Review of various liver retraction techniques in single incision laparoscopic surgery for the exposure of hiatus. J Minim Access Surg. 2015;11:198–202.CrossRef
23.
go back to reference Shi X, Karmali S, Sharma AM, et al. A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010;20:1171–7.CrossRef Shi X, Karmali S, Sharma AM, et al. A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010;20:1171–7.CrossRef
24.
go back to reference Gentileschi P, Camperchioli I, Benavoli D, et al. Laparoscopic single-port sleeve gastrectomy for morbid obesity: preliminary series. Surg Obes Relat Dis. 2010;6:665–9.CrossRef Gentileschi P, Camperchioli I, Benavoli D, et al. Laparoscopic single-port sleeve gastrectomy for morbid obesity: preliminary series. Surg Obes Relat Dis. 2010;6:665–9.CrossRef
25.
go back to reference Uslu HY, Erkek AB, Cakmak A, et al. Trocar site hernia after laparoscopic cholecystectomy. J Laparoendosc Adv Surg Tech. 2007;17:600–3.CrossRef Uslu HY, Erkek AB, Cakmak A, et al. Trocar site hernia after laparoscopic cholecystectomy. J Laparoendosc Adv Surg Tech. 2007;17:600–3.CrossRef
26.
go back to reference 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. J Am Coll Surg. 2013;216:1037–47.CrossRef 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. J Am Coll Surg. 2013;216:1037–47.CrossRef
27.
go back to reference Julliard O, Hauters P, Possoz J, et al. Incisional hernia after single-incision laparoscopic cholecystectomy: incidence and predictive factors. Surg Endosc. 2016;30:4539–43.CrossRef Julliard O, Hauters P, Possoz J, et al. Incisional hernia after single-incision laparoscopic cholecystectomy: incidence and predictive factors. Surg Endosc. 2016;30:4539–43.CrossRef
28.
go back to reference Buckley 3rd FP, Vassaur HE, Jupiter DC, et al. Influencing factors for port-site hernias after single-incision laparoscopy. Hernia. 2016;20:729–33.CrossRef Buckley 3rd FP, Vassaur HE, Jupiter DC, et al. Influencing factors for port-site hernias after single-incision laparoscopy. Hernia. 2016;20:729–33.CrossRef
29.
go back to reference Soricelli E, Iossa A, Casella G, et al. Sleeve gastrectomy and crural repair in obese patients with gastroesophageal reflux disease and/or hiatal hernia. Surg Obes Relat Dis. 2013;9:356–61.CrossRef Soricelli E, Iossa A, Casella G, et al. Sleeve gastrectomy and crural repair in obese patients with gastroesophageal reflux disease and/or hiatal hernia. Surg Obes Relat Dis. 2013;9:356–61.CrossRef
Metadata
Title
Reduced-Port Sleeve Gastrectomy for Morbidly Obese Japanese Patients: a Retrospective Case-Matched Study
Authors
Manabu Amiki
Yosuke Seki
Kazunori Kasama
Srinivasulu Pachimatla
Michiko Kitagawa
Akiko Umezawa
Yoshimochi Kurokawa
Publication date
01-10-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 10/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-03987-1

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