Hybrid Transvaginal Sleeve Gastrectomy

Introduction: Sleeve Gastrectomy is now recognized as a weight loss procedure in a staged fashion for high risk patients or increasingly as a primary procedure for non super-obese patients. Reducing the risks of hernia and infections is important in the morbid obese patient. The aim of the presentation is to describe the steps of a hybrid transvaginal sleeve gastrectomy, which reduces the number of trocars and provides an alternative extraction site


Methods:
A flexible gastroscope is introduced by a posterior colpotomy for visualization, and one trocar of 12 mm is used in the umbilicus for stapling. Also, for retraction, two 3mm trocars are inserted in the subcostal area. Ultrasonic shears from the umbilical trocar is used for greater curvature mobilization. A 60 mm green cartridges are used for a sleeve gastrectomy over a 40 Fr. Bougie. Suturing is also provided with a needle driver inserted in the umbilical trocar. Extraction is performed transvaginally.

Results: A gastrograffin swallow was performed postoperative day #1 was negative for leaks or stricture, and the patient resumed a liquid diet, and was discharged on postop #2. The patient achieved a similar weight loss than a regular laparoscopic sleeve gastrectomy, with minimal abdominal pain.

Conclusion: Hybrid transvaginal sleeve gastrectomy is feasible and provides in the short term, similar weight loss with lesser analgesia requirements.


Session: Video Channel

Program Number: V075

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