Trans-umbilical Two-site Laparoscopic Roux-en-Y Gastric Bypass: Results in 500 Patients

Wei-jei Lee, MD PhD, Jung-chien Chen, MD, Kong-han Ser, MD, Jun-juin Tsou, SPN, Yi-chih Lee, MHA. Min-Sheng General Hospital, National Taiwan University, Taiwan


Background: Single-incision laparoscopic surgery (SILS) has emerged recently but is difficult to be applied in more complicated gastric bypass surgery. According to the thought of SILX, we developed a modified technique (two-site technique) to perform laparoscopic Roux-en-Y gastric bypass (TS-LRYGBP).
Methods: A retrospective analysis from prospective collected data was performed. Patients who underwent TS-LRYGBP were included. Two small skin incision (17mm and 5 mm) with the subxyphoid skin puncture wounds were made for all patients. Demographics, operative time, length of stay (LOS), weight loss, effect on co-morbidity and mortality were evaluated.
Results: Between February 2009 and August 2011, a total of 500 underwent TS-LRYGBP at our institute. 60% were female, initial mean BMI 40.5 (30.1-60) Kg/m2. All procedures were completed by laparoscopic surgery but 18% of them required one to two more 5mm ports to complete the procedure. For the first 100 patients, operative time was 170.9 +30 min which was gradually decreasing to 140 + 14min. The mean LOS was 4.1 days at beginning and decreased to 3.5days. Weight loss was 25% at 1 year and 30% at 2 years. Major complication rate was 4% with one mortality case (0.2%). The patient’s satisfaction was higher than convention LRYGBP.
Conclusions: TS-LRYGBP is a safe and reproducible modified SILS bariatric procedure. This technique might generate minimal pain and achieve an excellent cosmetic satisfaction.

Session Number: Poster – Poster Presentations
Program Number: P452
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