Pure transumbilical SILS gastric bypass with mechanical circular gastrojejunal anastomosis feasibility.
BACKGROUND
Since Wittgrove introduced the laparoscopic version of the gastric bypass in 1994, the interest still remains in the decrease of the abdominal wall trauma in order to optimize the benefits of laparoscopy on postoperative pain, cosmesis, hospital stay, and convalescence in bariatric patients. This work is to report the feasibility of gastric bypass surgery by a pure transumbilical single-incision laparoscopic surgery (SILS) with a mechanical circular gastrojejunal anastomosis.


METHODS
Thirty-four patients (10 males and 24 females) were offered to receive gastric bypass with circular mechanical gastrojejunal anastomosis by Single Incision Laparoscopic Surgery (SILS) using pure transumbilical access. Anastomotic leak occurrence was the primary end-point. Patients demographics, operative time, additional trocarts, hemorrhage, intra abdominal abscess, length of post-operative stay, readmission, 30 days death, gastrojejunal anastomosis stricture, marginal ulcers, reflux complains, seromas, incisional hernias, and % excess BMI loss were also recorded in a prospective database.


RESULTS
Primary end-point showed no anastomotic leak occurrence during the hospital stay or during the first 30 post-operative days. SILS gastric bypass with a circular mechanical gastrojejunal anastomosis is feasible and seems to be safe.
Service de Chirurgie Digestive, CHU Charleroi, 92, boulevard P. Janson, 6000, Charleroi, Belgium, denis.pitot@chu-charleroi.be.
Denis
D
Pitot
Mazen
M
Takieddine
Ziad
Z
Abbassi
Apostolos
A
Agrafiotis
Laurence
L
Bruyns
Michel
M
Ceuterick
Nabil
N
Daoudi
Amaury
A
Dolimont
Abdelak
A
Soulimani
Pol
P
Vaneukem
D000328:Adult; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000209:etiology; D005240:Feasibility Studies; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D011446:Prospective Studies; D013270:Stomach / Q000601:surgery*; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery*