Hand-assisted laparoscopic bariatric surgery.
Bariatric surgery implies a major life-long rearrangement of the gastrointestinal tract to obtain a controlled weight reduction in a severe but nonmalignant disease. Obesity poses a special challenge to the laparoscopic surgeon. Laparoscopy is known to facilitate the perioperative phase for the patient, but is technically difficult to perform in morbidly obese subjects. Hand-assistance adds extra control in demanding procedures, and Hand-port systems for use in the thick abdominal wall are now available. Here we review the role of hand-assisted laparoscopy for common bariatric procedures and describe our technique for Hand-assisted laparoscopic Roux-en-Y Gastric bypass. Hand-assistance might be the well-blended mix for complex laparoscopic procedures in bariatric work, especially for surgeons working outside highly specialized laparoscopic centers.
Sundbom
M
M
Department of Surgery, University Hospital, Uppsala, Sweden. magnus.sundbom@kirurgi.uu.se
Gustavsson
S
S
D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D015904:Biliopancreatic Diversion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D015390:Gastric Bypass / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D015391:Gastroplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005773:Gastroscopy / Q000009:adverse effects / Q000379:methods*; D006225:Hand; D006801:Humans; D018579:Patient Selection; D011187:Posture; D016896:Treatment Outcome