title: Surgical results of single-incision transumbilical laparoscopic Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Conventional laparoscopic Roux-en-Y gastric bypass (LRYGB) has been the reference standard for bariatric surgery but requires 5-7 trocar incisions. We have developed a new procedure-single-incision transumbilical LRYGB (SITU-LRYGB)-that results in minimal scarring and is more cosmetically acceptable. To compare the surgical results and patient satisfaction between 5-port LRYGB and the novel SITU-LRYGB at a university hospital.
  
  
  METHODS
  We performed 5-port or SITU-LRYGB on 140 morbidly obese patients; the patients chose the operation method. We used a novel liver traction method and omega-umbilicoplasty specifically designed for SITU-LRYGB.
  
  
  RESULTS
  Before surgery, the patients in the 5-port surgery group were more obese than those in the SITU group (120.8 kg versus 108.9 kg, P = .013). The rate of hypertension was also greater in the former group. The operative time was longer for SITU-LRYGB (101.1 versus 81.1 min, P = .001) without increased intraoperative complications. The total morphine dose for the SITU group seemed to be greater but the difference was not statistically significant. No difference in complications was observed. Postoperatively, the percentage of excess body weight lost the SITU and 5-port surgery groups was 21.2% and 20.9%, 40.4% and 39.4%, 55.0% and 55.2%, 64.8% and 75.2%, and 75.4% and 78.2% at 1, 3, 6, 9, and 12 months, respectively. The SITU-LRYGB patients reported greater satisfaction related to scarring than those who had undergone 5-port surgery (score 4.57 versus 3.96, respectively, P = .005). No patient died.
  
  
  CONCLUSIONS
  Compared with conventional LRYGB, SITU-LRYGB resulted in acceptable complications, the same recovery, comparative weight loss, and better patient satisfaction related to scarring.
authors.affiliation: Bariatric and 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: 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; D004867:Equipment Design; D005260:Female; D015390:Gastric Bypass / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D017060:Patient Satisfaction; D013525:Surgical Instruments; D013537:Sutures; D016896:Treatment Outcome; D015431:Weight Loss