• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

WEIGHT-LOSS OUTCOMES OF SPIDER(r) SLEEVE GASTRECTOMY AT 6-MONTHS COMPARED TO TRADITIONAL LAPAROSCOPIC TECHNIQUE

Kathryn B Muir, MD, William V Rice, MD. William Beaumont Army Medical Center

Introduction

Laparoscopic sleeve gastrectomy (LSG) has become an acceptable primary stand-alone procedure for metabolic and weight-loss surgery. Traditional LSG involves multiple small abdominal incisions, similar to traditional laparoscopic cholecystectomy. Sleeve gastrectomy has also been performed using the single incision laparoscopic surgery (SILS) technique, to minimize scarring and improve ultimate cosmetic outcome. SILS is technically challenging due to the crossover of instruments. Recently, the single port instrument delivery extended reach (SPIDER®) surgical system has been introduced as another single incision modality for performing sleeve gastrectomy. This system minimizes the number of incisions needed while eliminating the technical challenges of instrument crossover. Use of this technique has been reported previously, however, outcomes of SPIDER® sleeve gastrectomy have not been compared to outcomes of traditional LSG. We hypothesized SPIDER® sleeve gastrectomy would not be inferior to traditional LSG.

Methods and Procedures

We performed a retrospective review of a prospectively collected database involving patients undergoing surgery between Aug 2011 and Sep 2013. All cases were performed by a single bariatric surgeon and at a single institution. Thirty-two patients underwent SPIDER sleeve gastrectomy versus thirty who underwent LSG. Our primary outcomes were change in BMI and percent excess weight loss (%EWL) at 6 months post-operatively. Secondary outcomes included length of operative time, intraoperative estimated blood loss (EBL), and overall complications.

Results

The demographics of our patients were examined and the only significant difference between the cohorts was mean initial BMI (SPIDER®=42.1, LSG=46.5, p<0.001). At 6 months post-operatively, mean %EWL was higher in the SPIDER® cohort (59.1%) than in the LSG cohort (48.3%) (p<0.005). This corresponded with an overall lower mean BMI in the SPIDER® cohort at 6-months versus those who underwent traditional LSG (31.1 and 35.5, respectively, p<0.0001). At the 6 month post-operative interval, despite differences in initial BMI, the overall change in BMI in each cohort was equivalent (SPIDER®=11.1, LSG=11.0, p=0.94). Mean operative time was longer in SPIDER® sleeve gastrectomy (107.4 min) compared to LSG (87.4 min) (p<0.001). EBL was not different between the two techniques (32.1mL and 32.3mL, p=0.94). With regard to complications, there was one post-operative hemorrhage in each group; one surgical site infection in the LSG cohort, and one negative diagnostic laparoscopy in the SPIDER® cohort due to uncharacteristic abdominal pain on post-operative day #1.

Conclusions

Based on the results at 6 months post-operatively, SPIDER® sleeve gastrectomy is not inferior to LSG with regard to decrease in BMI or %EWL. The increased %EWL observed in the SPIDER® cohort is likely due to patient selection bias given the use of a new technique, though other explanations cannot be excluded. This retrospective study shows that the SPIDER® technique is a viable alternative to traditional LSG with regard to weight-loss outcomes.

71

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons