Gastrectomía vertical laparoscópica a través de 3 puertos: viabilidad y resultados a corto plazo en en una serie de 25 pacientes con hiperobesidad

Abstract

IntroductionThe aim of this paper is to propose our technique, namely three-port laparoscopic sleeve gastrectomy (TPLSG), to define the feasibility and expose the short-outcomes, as an alternative between the standard laparoscopic approach and the single incision (SILSG) for such patients. Material and methodsWe conducted a prospective study of 25 patients: 12 male and 13 female, reporting a mean BMI of 53kg/m2 (range: 50-72) and a mean age of 38 years (range: 29-55). To evaluate the feasibility of our technique we have always respecting 3 pre-operatives conditions: BMI ≥ 50kg/m2. Preoperative abdominal US or CT to measure the liver and determine the hepato-splenic characteristics. «Intent to treat by 3 ports» (2 of 5mm and one 12mm in diameter). The short outcomes follow-up include: operative time, conversion, transfusions, fistula, reinterventions and parietal herniation at one and three months after surgery. ResultsHepatomegaly was present in 19 (76%) patients, and it's greater on the left hepatic lobe in 9 (36%) patients. The mean operation time was 72min (range: 50-110). No per-operative complications were observed. Conversion to four ports procedure was necessary in one patient. The mean hospital stay was 3 days (range: 2-5). No mortality and 30th POD morbidity rate was reported. No patient developed an incisional hernia to date. ConclusionThe TPLSG reduces the ports in number and in size and subsequently the parietal trauma, it also an instrumental triangulation, making surgery safe and reproducible.