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Hybrid NOTES Sleeve Gastrectomy for Morbid Obesity

BACKGROUND: Sleeve gastrectomy is increasingly used for the treatment of morbid obesity. Natural Orifice Translumenal Endoscopic Surgery (NOTES) is a novel technique in the field of modern surgery. While awaiting technological refinements, necessary for realizing true NOTES procedures, “hybrid” NOTES and single port techniques have been increasingly reported. In this study, we describe our preliminary experience in hybrid NOTES sleeve gastrectomy.
METHODS: The procedure was attempted in 16 women with a mean age of 33 years (22-61) and a mean BMI of 42 (35-49). The technique consisted in used three ports including one 12-mm (umbilicus), one 15-mm (vagina), and one 5-mm (left flank).
RESULTS : The procedure was accomplished without conversion in 12 patients (75 %). No postoperative complications were encountered. The mean hospital stay was 48 hours (24-96). Patients had upper GI series at 8 and 15 days, respectively. No abnormalities were found. Mean follow-up was 6 months (2-14).
CONCLUSIONS: Vaginal hybrid NOTES sleeve gastrectomy is feasible and safe. Additional evaluation is, however, needed in order to assess the advantages of this technique.


Session: Poster

Program Number: P250

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