Comparison of two specimen retrieval techniques in laparoscopic sleeve gastrectomy: what is the role of endobag?
Laparoscopic sleeve gastrectomy (LSG) has become a popular stand-alone treatment for morbid obesity. However, removal of the gastric specimen could be a challenging step due to its large size relative to the width of the trocar site.



We aimed to compare a simplified retrieval technique for extraction of the gastric specimen without an endobag with conventionally performed specimen retrieval using an endobag.



A case-control study was conducted recruiting patients undergoing LSG. Patient's demographics, preoperative characteristics, intra-operative, and postoperative variables were compared between the two groups according to the technique of gastric specimen removal.



A total of 193 patients (60.6% female) were enrolled into case (n = 100) and control groups (n = 93). Mean ± SD age and BMI of patients were 35.64 ± 11.84 years and 47.28 ± 8.22 Kg/m2, respectively with no significant difference between groups. Median (25th, 75th inter-quartile), extraction time was significantly reduced in the non-endobag group compared to the endobag group (3.5 [2.5-4.5] min vs. 6.5 [3.4-8.2] min, p = 0.03).Patients of both groups had similar intra-operative and trocar site complications (hernia and wound infection) (3% for endobag group and 3.3 % for non-endobag group). The median (25-75% [IQR]) LOS was also comparable between endobag and non-endobag patients (3[2-3] vs. 3[2-4] days, p = 0.84). No difference was observed between the two groups for weight loss and comorbidity resolution.



Non-endobag technique for gastric specimen retrieval is safe and feasible with substantial saving in operative time and comparable intra-operative and postoperative outcomes to the conventional retrieval technique.
Department of Bariatric and Metabolic Surgery, Weight Loss Center, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, 121 DeKalb Ave, Brooklyn, NY, 11201, USA.
Saeed
S
Shoar
Metabolic & Bariatric Surgery Department, Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar.
Shereen
S
Aboutaleb
Metabolic & Bariatric Surgery Department, Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar.
Mohsen
M
Karem
Metabolic & Bariatric Surgery Department, Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar.
Moataz M
MM
Bashah
Metabolic & Bariatric Surgery Department, Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar.
Mohamed
M
AlKuwari
Metabolic & Bariatric Surgery Department, Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar.
Davit
D
Sargsyan
Department of Bariatric and Metabolic Surgery, Weight Loss Center, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, 121 DeKalb Ave, Brooklyn, NY, 11201, USA. saber6231@gmail.com.
Alan A
AA
Saber
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
Bariatric surgery; Gastric specimen removal; Laparoscopic sleeve gastrectomy; Specimen retrieval