Department of Gastrointestinal Surgery, Institute of Digestive and Metabolic Diseases, Hospital Clínic of Barcelona, Villarroel 170, 08036, Barcelona, Spain.
Surg Endosc. 2012 May;26(5):1247-53. doi: 10.1007/s00464-011-2002-9. Epub 2012 Apr 5.
Sleeve gastrectomy is gaining relevance in the surgical armamentarium against obesity. The transumbilical single port has proved to be an attractive and safe alternative for a variety of minimally invasive abdominal surgeries. The purpose of this study is to evaluate the initial results of a group of patients operated by single-port sleeve gastrectomy compared with a group operated by conventional laparoscopic technique.
We present a prospective cohort study of two groups of consecutive patients with body mass index (BMI) between 35 and 55 kg/m(2), with an indication of sleeve gastrectomy. In 20 patients, we used a transumbilical single-port (TUSP) technique; in 22 patients, we used the conventional laparoscopic (CL) technique. All surgeries were performed between June and December 2009 in the Gastrointestinal Surgery Department of Hospital Clínic, Barcelona. The same medical team, in a standardized fashion, carried out all surgeries.
There were no differences between groups in body mass index (BMI), age, sex, number and type of comorbidities, or history of previous abdominal surgery. Operative time (79.2 min) was significantly higher in the TUSP group (p = 0.002) than in the CL group (54.1 min). There were no conversions to open surgery in any of the patients operated upon via CL, but one conversion to laparoscopic surgery, requiring the addition of three trocars, in the TUSP group. There were no significant differences in morbidity or hospital stay between the groups. Percentage excess weight loss and excess BMI loss at 3 and 6 months, as indexes for improvement and resolution of comorbidities associated with obesity, showed that there were no significant differences between the groups.
Transumbilical single-port sleeve gastrectomy has proved to be safe, technically feasible, and reproducible, with results that are similar to those obtained with conventional laparoscopic surgery.
袖状胃切除术在肥胖症的外科治疗中越来越受到重视。经脐单孔已被证明是一种具有吸引力和安全性的替代方法，可用于各种微创腹部手术。本研究的目的是评估一组接受单孔袖状胃切除术患者的初步结果，并与接受传统腹腔镜技术治疗的一组患者进行比较。
我们进行了一项前瞻性队列研究，纳入了两组连续的 BMI 介于 35 至 55kg/m²之间且有袖状胃切除术指征的患者。在 20 例患者中，我们使用了经脐单孔（TUSP）技术；在 22 例患者中，我们使用了传统腹腔镜（CL）技术。所有手术均于 2009 年 6 月至 12 月在巴塞罗那 Clinic 医院胃肠外科进行。同一医疗团队以标准化的方式进行了所有手术。
两组患者在 BMI、年龄、性别、合并症数量和类型或既往腹部手术史方面无差异。TUSP 组的手术时间（79.2 分钟）显著长于 CL 组（p=0.002）（54.1 分钟）。在接受 CL 治疗的患者中，没有转为开放性手术的病例，但在 TUSP 组中有 1 例转为腹腔镜手术，需要增加 3 个 trocar。两组患者的发病率和住院时间均无显著差异。3 个月和 6 个月时的体重减轻百分比和 BMI 减轻百分比作为改善和解决与肥胖相关的合并症的指标，表明两组之间无显著差异。
经脐单孔袖状胃切除术安全、技术可行且可重复，其结果与传统腹腔镜手术相似。
