Single-port laparoscopic sleeve gastrectomy as a routine procedure in 1000 patients

Abstract

Background: Single-port laparoscopic sleeve gastrectomy (SPSG) is performed routinely in our department as an alternative to a conventional laparoscopic approach.

Objectives: The aim of this study was to report our surgical results and follow-up outcome after SPSG.

Setting: Department of Digestive Minimally Invasive Surgery, Antoine Béclère Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Saclay University, France.

Methods: Data from consecutive patients who underwent SPSG in our institution between August 2010 and July 2015 were prospectively collected and retrospectively analyzed. Patients with more than 1-year follow-up were included in our analysis for weight loss and co-morbidity.

Results: A total of 1000 patients underwent SPSG during the study period. Median body mass index was 42.6 kg/m² (range: 33.8-84.6 kg/m²). Median operative time was 112 minutes (range: 50-360 min) and decreased over the years. Completion of the procedure required introduction of an extraport in 78 patients (7.8%). Postoperative mortality and morbidity rates were .1% and 8.1%, respectively. Relaparoscopy and/or endoscopic treatment were required to treat intra-abdominal bleeding in 24 patients (2.4%) and staple-line leakage in 28 patients (2.8%). Five hundred forty-six patients were considered for 1-year follow-up evaluation. Mean excess weight loss was 69% after 1 year and 62.2% after 2 years. Incisional hernia from the trocar site occurred in 20 (3.7%) patients.

Conclusion: Sleeve gastrectomy can be routinely performed using a single-incision laparoscopic technique with equivalent outcomes of surgical morbidity and weight loss compared with conventional laparoscopic surgery. Prospective comparative studies are necessary to assess the potential benefits of this minimally-invasive approach.

Keywords: Bariatric surgery; LESS; Obesity; SILS; Sleeve gastrectomy.