Background: The sleeve gastrectomy procedure has been gaining popularity because of its simplicity and favorable outcomes. This study reports the experience with a single-access approach to laparoscopic sleeve gastrectomy in super-super obese patients. Methods: Four super-super obese patients having a mean body mass index of 62.7 kg/m2 underwent single-access laparoscopic sleeve gastrectomy. The same perioperative protocol and operative techniques were implemented for all 4 patients. Results: A total of 4 single-access laparoscopic sleeve gastrectomies in super-super obese patients were successfully performed using this technique. Mean operating time was 126 minutes. One patient required the insertion of an additional trocar. There were no mortalities or postoperative complications noted. Most comorbidities either improved or resolved during a mean follow-up of 5.3 months. Conclusion: Single-access laparoscopic sleeve gastrectomy in the super-super obese is safe, feasible, and reproducible.
Himpens J., Dapri G., Cadière GBA prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450-1456.
2.
Tagaya N., Kasama K., Kikkawa R., et al. Experience with laparoscopic sleeve gastrectomy for morbid versus super morbid obesity. Obes Surg. 2009;19:1371-1376.
3.
Moy J., Pomp A., Dakin G., Parikh M., Gagner M.Laparoscopic sleeve gastrectomy for morbid obesity. Am J Surg . 2008;196:e56-e59.
4.
Fuks D., Verhaeghe P., Brehant O., et al. Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery. 2009;145:106-113.
Saber AA, El-Ghazaly THEarly experience with single incision transumbilical laparoscopic adjustable gastric banding using the SILS port. Int J Surg. 2009;7:456-459.
9.
Saber AA, El-Ghazaly THSingle-incision transumbilical laparoscopic splenic cyst unroofing: first reported case. Accepted Am Surg.2009.
10.
Saber AA, El-Ghazaly TH, Minnick DBSingle port access transumbilical laparoscopic Roux-en-Y gastric bypass using the SILS port: First reported case. Surg Innov. 2009;16:343-347.
11.
Higa KD, Ho T., Boone KBLaparoscopic Roux-en-Y gastric bypass: technique and 3-year follow-up. J Laparoendosc Adv Surg Tech A. 2001;11:377-382.
12.
Bucher P., Pugin F., Morel P.Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis. 2008;23: 1013-1016.
13.
Bucher P., Pugin F., Morel P.Transumbilical single incision laparoscopic sigmoidectomy for benign disease . Colorectal Dis. 2010;12:61-65.
Nguyen NT, Reavis KM, Hinojosa MW, Smith BR, Wilson SELaparoscopic transumbilical sleeve gastrectomy without visible abdominal scars . Surg Obes Relat Dis. 2009;5:275-277.
16.
Reavis KM, Hinojosa MW, Smith BR, Nguyen NTSingle-laparoscopic incision transabdominal surgery sleeve gastrectomy. Obes Surg. 2008;18:1492-1494.
17.
Teixeira J. , McGill K., Binenbaum S., Forrester G.Laparoscopic single-site surgery for placement of an adjustable gastric band: initial experience. Surg Endosc . 2009;23:1409-1414.
18.
Teixeira J. , McGill K., Koshy N., McGinty J., Todd G.Laparoscopic single-site surgery for placement of adjustable gastric band: a series of 22 cases. Surg Obes Relat Dis.2010;6:41-45.
19.
Tacchino RM , Greco F., Matera D.Laparoscopic gastric banding without visible scar: a short series with intraumbilical SILS [published online ahead of print July 15, 2009]. Obes Surg. doi:10.1007/s11695-009-9908-5.
20.
D’Alessio A., Piro E., Tadini B., Beretta F.One-trocar transumbilical laparoscopic-assisted appendectomy in children: our experience. Eur J Pediatr Surg . 2002;12:24-27.
Ateş O., Hakgüder G., Olguner M., Akgür FMSingle-port laparoscopic appendectomy conducted intracorporeally with the aid of a transabdominal sling suture. J Pediatr Surg. 2007;42:1071-1074.
23.
Varshney S., Sewkani A., Vyas S., et al. Single-port transumbilical laparoscopic-assisted appendectomy . Indian J Gastroenterol. 2007;26:192.
24.
Palanivelu C. , Rajan PS, Rangarajan M., Parthasarathi R., Senthilnathan P., Praveenraj P.Transumbilical endoscopic appendectomy in humans: on the road to NOTES: a prospective study. J Laparoendosc Adv Surg Tech A. 2008;18: 579-582.
25.
Hodgett SE, Hernandez JM, Morton CA, Ross SB, Albrink M., Rosemurgy ASLaparoendoscopic single site (LESS) cholecystectomy. J Gastrointest Surg.2009;13: 188-192.
26.
Zhu JF, Hu H., Ma YZ, Xu MZTotally transumbilical endoscopic cholecystectomy without visible abdominal scar using improved instruments. Surg Endosc. 2009;23: 1781-1784.
Piskun G., Rajpal S.Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A. 1999;9:361-364.
29.
Bresadola F. , Pasqualucci A., Donini A., et al. Elective transumbilical compared with standard laparoscopic cholecystectomy. Eur J Surg. 1999;165:29-34.
Tacchino R. , Greco F., Matera D.Single-incision laparoscopic cholecystectomy: surgery without a visible scar. Surg Endosc. 2009;23:896-899.
32.
Hong TH, You YK, Lee KHTransumbilical single-port laparoscopic cholecystectomy: scarless cholecystectomy . Surg Endosc. 2009;23:1393-1397.
33.
Romanelli JR , Mark L., Omotosho PASingle port laparoscopic cholecystectomy with the TriPort system: a case report. Surg Innov. 2008;15:223-228.
34.
Katkhouda N. , Moazzez A., Popek S., et al. A new and standardized approach for trocar placement in laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2009;23:659-662.
