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Three-port gastrectomy feasible, offers similar weight loss to LSG
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Laparoscopic sleeve gastrectomy can be performed without using a retractor device, requiring one less incision for a less-invasive procedure, according to research published in Bariatric Surgical Practice and Patient Care.
Cüneyt Kirkil, MD, from the department of general surgery at Firat University in Turkey, and colleagues wrote that this three-port sleeve gastrectomy (3PSG) could offer a middle ground between a traditional LSG — which uses between four to six ports — and a single-incision laparoscopic surgery (SILS-SG), which is still being evaluated.
“Reducing the number of trocar has become a target for minimally invasive surgery,” they wrote. “Even though SILS-SG has been proposed as safe and effective with good early postoperative results and less wound-related complications, navigating the complex instruments and achieving triangulation can be challenging for inexperienced surgeons. Therefore, SILS-SG can be more difcult than conventional LSG.”
Kirkil and colleagues analyzed data from two cohorts comprising 70 patients each who underwent either 3PSG or LSG to compare the practicability and efficacy of each procedure.
Although the mean operation time was longer in the 3PSG group (47.2±8.9 min vs. 40.7±7.5 min; P < .001), they found no intraoperative complications in either group.
Investigators noted wound infection at the 12 mm port site in 5 cases in the 3PSG group compared with 15 cases in the LSG group (P < .05).
After the mean follow-up time of 9.5±1.1 months, researchers found that the percentage of excess BMI loss was similar in the 3PSG group compared with the LSG group (69.3±29.7% vs. 66.1±26% ; P > 0.05.)
Kirkil and colleagues wrote that 3PSG does not require highly trained surgeons and does not need any specialized equipment other than what is needed for a conventional LSG procedure.
“3PSG may be challenging for one who lacks experience with conventional LSG,” they wrote. “But we routinely perform conventional LSG using four ports.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.
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