Page 4 - Journal of World Association of Laparoscopic Surgeons

Specimen Extraction after Sleeve Gastrectomy

Fig. 1: Trocar locations Fig. 2: Specimen grasping and pull into the 12-mm trocar

Table 1: Patient characteristics
N : 129
Sex Male 24 (18.6%)
Female 105 (81.4%)
Age Mean ± SD 38 ± 8.7
BMI Mean ± SD 45.7 ± 6
Comorbidity Hypertension (HT) 28 (21.7%)
Diabetes mellitus (DM) 51 (39.5%)
Pulmonary comorbidity 16 (12.4%)
ASA score II 98 (76%)
III 31 (24%)

Table 2: Intraoperative and postoperative results
N : 129
Fig. 3: Extraction of the entire specimen via the 12-mm trocar Operation Sleeve gastrectomy 117 (90.7%)
Sleeve gastrectomy 12 (9.3%)
extracted out of the abdomen by the large curvature, with the help + cholecystectomy
of a gauze, by avoiding excessive traction (Fig. 3). Operation time (min) Mean ± SD 75.7 ± 19.4
The patients’ demographic characteristics (age, sex), body Specimen extraction time Mean ± SD 2.38 ± 1.19
mass index (BMI), comorbid status, ASA score, intraoperative (min)
complications, specimen extraction time, and operation time Specimen rupture 3 (2.3%)
were recorded. Specimen extraction time was obtained by the Wound infection 0 (0%)
retrospective review of the operation video recordings in the first Port site hernia 0 (0%)
55 cases, and from prospectively recorded data in subsequent cases.
All patients were controlled on the 10th postoperative day, and on
the 1st, 3rd, 6th, and 12th months by the surgical team. Wound-site
infection status and trocar-site hernia status were recorded. Trocar band gastroplasty. A cholecystectomy was performed in 12 (9.3%)
site hernia status was evaluated by a clinical examination. In the patients in the same session. A cholecystectomy specimen was
statistical evaluation, a descriptive method was used. extracted from the same area. Four (3.1%) patients had leakage
after the sleeve gastrectomy. One of them was spontaneously
closed. Others were treated with endoscopic treatment methods.
results The average operative time and specimen removal time were
A total of 129 patients who underwent a laparoscopic sleeve 75.7 ± 19.4, 2.38 ± 1.9 minutes, respectively. The fundus perforation
gastrectomy were included in the study. Demographic characteristics was developed in three (2.3%) patients during extraction. In
(age, sex) and preoperative (body mass index, comorbidities, addition to prophylactic antibiotherapy, antibiotic treatment
ASA score) characteristics of the patients are summarized in was applied in the postoperative follow up of these patients. The
Table 1. All operations were completed laparoscopically. The average follow up period of the patients was 13.9 ± 6.2 months.
sleeve gastrectomy was performed to one patient owing to gastric During the follow up period, no wound site infection and trocar
plication and to the other patient owing to the revision after vertical site hernia were seen in any patient (Table 2).

2 World Journal of Laparoscopic Surgery, Volume 12 Issue 1 (January–April 2019)