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. 2015;28 Suppl 1(Suppl 1):65-8.
doi: 10.1590/S0102-6720201500S100018.

TECHNICAL ASPECTS OF LAPAROSCOPIC SLEEVE GASTRECTOMY

[Article in English, Portuguese]
Almino Cardoso Ramos  1 , Eduardo Lemos de Souza Bastos  1 , Manoela Galvão Ramos  1 , Nestor Tadashi Suguitani Bertin  1 , Thales Delmondes Galvão  1 , Raphael Torres Figueiredo de Lucena  1 , Josemberg Marins Campos  2
Affiliations

TECHNICAL ASPECTS OF LAPAROSCOPIC SLEEVE GASTRECTOMY

[Article in English, Portuguese]
Almino Cardoso Ramos et al. Arq Bras Cir Dig. 2015.

Abstract
in English, Portuguese

Background: The vertical gastrectomy indications for surgical treatment of morbid obesity have increased worldwide. Despite this increase, many aspects of surgical technique still remains in controversy.

Aim: To contribute presenting surgical details in order to better realize the vertical gastrectomy technique in bariatric surgery.

Methods: Technical systematization, patient preparation, positioning of the trocars, operative technique and postoperative care are presented in details.

Results: During 12 months were enrolled 120 patients undergoing GV according to the technique described herein. The results are published in another ABCD article (ABCD 2015;28(Supl.1):61-64) in this same volume and number.

Conclusion: The surgical technique proposed here presented itself viable and facilitating the surgeon's work on difficult points of the vertical gastrectomy.

Racional: : As indicações da gastrectomia vertical no tratamento cirúrgico da obesidade mórbida têm aumentado no mundo todo. Apesar deste aumento, diversos aspectos relativos à técnica operatória têm sido controversos.

Objetivo: : Contribuir com detalhes cirúrgicos afim de melhor a técnica da gastrectomia vertical na cirurgia bariátrica.

Métodos: : A sistematização técnica, o preparo do paciente, o posicionamento dos trocárteres, a técnica operatória e cuidados do pós-operatório são apresentados em detalhes.

Resultados: : Durante 12 meses foram incluídos 120 pacientes submetidos à GV de acordo com a técnica aqui descrita. Os resultados estão publicados em outro artigo do ABCD (ABCD 2015;28(Supl.1):61-64) neste mesmo volume e número.

Conclusão: : A técnica cirúrgica aqui proposta apresentou-se viável facilitando o trabalho do cirurgião em pontos difíceis da gastrectomia vertical.

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Conflict of interest statement

Conflicts of interest: none

Figures

FIGURE 1
FIGURE 1. - Positioning of the trocars for laparoscopic SG
FIGURE 2
FIGURE 2. - Removal of the fat pad near the esophagogastric junction
FIGURE 3
FIGURE 3. - Dissection of the great gastric curvature in the proximal direction to the oesophagogastric angle
FIGURE 4
FIGURE 4. - Dissection of the great gastric curvature distally up to 2 cm from the pylorus
FIGURE 5
FIGURE 5. - Full release of the gastric fundus near the diaphragmatic crus
FIGURE 6
FIGURE 6. - Mechanical stapler positioned in the antrum next to the pylorus for the first shot
FIGURE 7
FIGURE 7. - Mechanical stapler positioned for early gastric body tubing with gastric tube 32 Fr modeling the stomach
FIGURE 8
FIGURE 8. - Mechanical stapler positioned near the gastroesophageal transition to perform the last shot
FIGURE 9
FIGURE 9. - Continuous oversuture being held in stapling line with absorbable suture in a single layer
FIGURE 10
FIGURE 10. - Oversuture completed on the stapling line and final appearance of the gastric tube
See this image and copyright information in PMC

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