Optimization of Trocar Sites in Laparoscopic Sleeve Gastrectomy: Experience From 4.450 Cases

Öz

Background: Obesity is seen in almost one in four adults today and is expected to have an increasing incidence in the coming years. It is predicted that one in every two adults in the USA will be obese by 2030. Laparoscopic sleeve gastrectomy (LSG) is the most frequently preferred surgical method with proven efficacy for the treatment of obesity. In this study, we aimed to describe our experi-ence with the trocar sites we optimized and standardized for use in LSG. Methods: 4450 patients who had LSG performed by a single surgeon (Senior author) were included in the study. The optimized trocar sites determined according to previous surgical experience were examined in terms of their intended use and advantages. Results: No trocar site revision or additional trocar use was required during LSG in any of the 4450 cases in which the trocar sites were optimized. Conclusions: We consider that the technique presented in our study minimizes the risk of insuffi-cient exposure and provides anatomical standardization. The insertion of two additional trocars compared to the three-trocar technique does not increase postoperative herniation risk or esthetic concerns. Keywords: Laparoscopic sleeve gastrectomy, trocar, obesity surgery

Anahtar Kelimeler

• Laparoscopic sleeve gastrectomy
• trocar
• obesity surgery

Laparoskopik Sleeve Gastrektomide Trokar Yerlerinin Optimizasyonu: 4.450 Vakadan Elde Edilen Deneyim

Öz

Amaç: Obezite günümüzde neredeyse dört yetişkinden birinde görülmektedir ve önümüzdeki yıllar-da görülme sıklığının artması beklenmektedir. ABD'de her iki yetişkinden birinin 2030 yılına kadar obez olacağı tahmin edilmektedir. Laparoskopik sleeve gastrektomi (LSG), obezite tedavisinde etkin-liği kanıtlanmış en sık tercih edilen cerrahi yöntemdir. Bu çalışmada, LSG'de kullanım için optimize ettiğimiz ve standardize ettiğimiz trokar bölgeleri ile ilgili deneyimimizi anlatmayı amaçladık. Materyal ve Metod: Tek bir cerrah (Kıdemli yazar) tarafından LSG uygulanan 4450 hasta çalışmaya dahil edildi. Önceki cerrahi deneyime göre belirlenen optimize edilmiş trokar bölgeleri, amaçlanan kullanımları ve avantajları açısından incelendi. Bulgular: Trokar bölgelerinin optimize edildiği 4450 vakanın hiçbirinde LSG sırasında trokar bölgesi revizyonu veya ek trokar kullanımı gerekmedi. Sonuç: Çalışmamızda sunulan tekniğin yetersiz pozlama riskini en aza indirdiğini ve anatomik stand-ardizasyon sağladığını düşünüyoruz. Üç trokarlı tekniğe kıyasla iki ek trokar yerleştirilmesi, ameliyat sonrası herniasyon riskini veya estetik kaygıları artırmaz. Anahtar Kelimeler: Laparoskopik sleeve gastrektomi, trokar, obezite cerrahisi

Anahtar Kelimeler

• laparoskopik sleeve gastrektomi
• obezite cerrahisi
• trokar

Kaynakça

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