title: Three trocar laparoscopic Roux-en-y gastric bypass: a novel technique en route to the single-incision laparoscopic approach.
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass is the gold standard bariatric procedure. Typically, the procedure necessitates five to seven small skin incisions for trocar placement. The senior author (AA Saber) has developed a three-trocar approach for laparoscopic Roux-en-Y gastric bypass.
  
  
  METHODS
  Sixteen patients underwent triple-incision laparoscopic Roux-en-Y gastric bypass between May 2009 and August 2009. The same surgeon performed all surgical interventions. The umbilicus was the main point of entry for all patients and the same operative technique and perioperative protocol were used in all patients.
  
  
  RESULTS
  A total of sixteen triple-incision laparoscopic Roux-en-Y gastric bypasses were performed. The procedures were successfully performed in all patients. Mean operating time was 145.4 min. None of the patients required conversion to an open procedure. There were no mortalities or post-operative technical complications noted during the immediate post-operative period.
  
  
  CONCLUSIONS
  Three trocar laparoscopic Roux-en-Y gastric bypass is safe, technically feasible and reproducible. This technique may be considered a "precursor" to single-incision laparoscopic Roux-en-Y gastric bypass.
authors.affiliation: Michigan State University, Kalamazoo Center for Medical Studies, 1000 Oakland Drive, Kalamazoo, MI 49008, USA. Saber6231@gmail.com
authors.forename: Alan A
authors.initials: AA
authors.lastname: Saber
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Elgamal
authors.forename: Tarek H
authors.initials: TH
authors.lastname: El-Ghazaly
authors.forename: Alain R
authors.initials: AR
authors.lastname: Elian
authors.forename: Aditya V
authors.initials: AV
authors.lastname: Dewoolkar
authors.forename: Abir Hassan
authors.initials: AH
authors.lastname: Akl
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D010147:Pain Measurement; D012494:Sampling Studies; D013525:Surgical Instruments; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery