Morales-Conde Salvador, Dominguez Guillermo, Gomez Jesus Cañete, Socas María, Barranco Antonio, Moreno Joaquin García, Padillo Francisco Javier
Department of General and Digestive Surgery, Virgen del RocíoUniversity Hospital, Sevilla, Spain.
Surg Innov. 2013 Aug;20(4):NP9-11. doi: 10.1177/1553350611427548. Epub 2011 Dec 4.
Sleeve gastrectomy is a recent, purely restrictive procedure in bariatric surgery that has shown results similar to gastric bypass over the short and middle term. At the same time, single-port access surgery has fostered the development of new techniques and methods seeking better cosmetic results and less postoperative pain, while maintaining the satisfactory results obtained by the standard laparoscopic approach. One of the problems associated to single-access surgery is the lack of traction and the difficulties to retract the liver. The authors' aim was to try to avoid additional trocars or sutures in order to perform pure single-incision surgery, using 2 magnetic forceps.
The authors present the case of a 51-year-old morbidly obese female (body mass index = 44.82) who underwent a pure single-access laparoscopic sleeve gastrectomy with no additional trocars or sutures and assisted by 2 neodymium magnetic forceps: one to retract the liver and the other to retract the stomach in order to provide sufficient triangulation for adequate exposure of the surgical field during dissection.
The procedure was completed in 120 minutes. No preoperative or postoperative complications were recorded, and the patient was discharged 2 days after surgery.
Single-port access sleeve gastrectomy assisted by magnetic forceps is feasible and safe in the hands of experienced laparoscopic surgeons, solving one of the problems associated to this type of surgery, that is, the need for an additional trocar and needles or sutures to retract the liver and stomach in order to perform the operation.
袖状胃切除术是近年来减肥手术中一种单纯的限制性手术，在短期和中期显示出与胃旁路手术相似的效果。同时，单孔入路手术促进了新技术和方法的发展，旨在获得更好的美容效果和减轻术后疼痛，同时保持标准腹腔镜手术所取得的满意效果。与单孔入路手术相关的问题之一是缺乏牵引力以及牵拉肝脏困难。作者的目的是尝试避免额外的套管针或缝线，以便使用两把磁力钳进行单纯的单切口手术。
作者报告了一例51岁病态肥胖女性（体重指数=44.82）的病例，该患者接受了单纯的单孔腹腔镜袖状胃切除术，未使用额外的套管针或缝线，并在两把钕磁力钳的辅助下进行手术：一把用于牵拉肝脏，另一把用于牵拉胃，以便在解剖过程中提供足够的三角定位，充分暴露手术视野。
手术在120分钟内完成。未记录到术前或术后并发症，患者术后2天出院。
在经验丰富的腹腔镜外科医生手中，磁力钳辅助下单孔入路袖状胃切除术是可行且安全的，解决了这类手术相关的一个问题，即需要额外的套管针和针或缝线来牵拉肝脏和胃以进行手术。
