title: A novel surgical technique: single-incision transumbilical laparoscopic Roux-en-Y gastric bypass.
abstract: Conventional laparoscopic Roux-en-Y gastric bypass (LRYGB) is a gold standard for bariatric surgery, but the procedure requires five to seven incisions for placement of multiple trocars and thus may produce less-than-ideal cosmetic results. We have developed a new approach, single-incision transumbilical LRYGB (SITU-LRYGB) to treat morbid obesity. We compared the surgical results and patient satisfaction in a study of five-port LRYGB and SITU-LRYGB. Fifty morbidly obese patients (14 males, 36 females) underwent either Roux-en-Y gastric bypass with five-port LRYGB or the SITU-LRYGB approach. During the operation, we used a novel intraoperative liver traction method with a "liver suspension tape" that we specifically designed for SITU-LRYGB. Compared to five-port surgery with SITU-LRYGB, there were no intraoperative complications, wound healing was excellent, and there was no abdominal scarring. SITU surgical time was longer than that with five-port LRYGB (99.8 vs. 67.6 min, P < 0.001). Patients treated with the five-port method were more obese than those in the SITU group (127.9 vs. 112.4 kg, P = 0.016). After the bariatric surgery, no difference in comorbidity was found in both groups. Patient satisfaction was greater with SITU than with the five-port method (4.48 vs. 3.96, P = 0.006). Roux-en-Y gastric bypass can be successfully achieved via a single umbilical incision, a method that provides a short operative time and good recovery and eliminates abdominal scarring.
authors.affiliation: Bariatric & Metabolic International Surgery Center, E-Da Hospital, Kaohsiung, Taiwan. dr.ckhuang@hotmail.com
authors.forename: Chih-Kun
authors.initials: CK
authors.lastname: Huang
authors.forename: Sheng-Fa
authors.initials: SF
authors.lastname: Yao
authors.forename: Chi-Hsien
authors.initials: CH
authors.lastname: Lo
authors.forename: Jer-Yiing
authors.initials: JY
authors.lastname: Houng
authors.forename: Yaw-Sen
authors.initials: YS
authors.lastname: Chen
authors.forename: Po-Huang
authors.initials: PH
authors.lastname: Lee
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery; D017060:Patient Satisfaction; D013536:Suture Techniques; D055815:Young Adult