Evolution and Standardisation of Techniques in Single-Incision Laparoscopic Bariatric Surgery

• Published in: Obesity surgery 2018-02, Vol.28 (2), p.574-583
• Main Authors: Praveen Raj, P., Bhattacharya, Siddhartha, Parthasarathi, R., Senthilnathan, P., Rajapandian, S., Saravana Kumar, S., Palanivelu, C.
• Format: Article
• Language: English
• Subjects: Adult; Bariatric Surgery - methods; Bariatric Surgery - standards; Bariatric Surgery - trends; Female; Gastrectomy - adverse effects; Gastrectomy - methods; Gastrectomy - trends; Gastric Bypass - adverse effects; Gastric Bypass - methods; Gastric Bypass - trends; Gastrointestinal surgery; How I Do It; Humans; Laparoscopy; Laparoscopy - methods; Laparoscopy - standards; Laparoscopy - trends; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity; Obesity, Morbid - pathology; Obesity, Morbid - surgery; Reference Standards; Surgery; Surgical outcomes; Surgical techniques; Surgical Wound - pathology; Suture Techniques - standards; Sutures - standards; Treatment Outcome; Young Adult
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-017-3036-4

Bariatric surgery has proven benefits for morbid obesity and its associated comorbidities. Laparoscopic approach is well established for bariatric surgery. Single-incision laparoscopic surgery (SILS) offers even more minimally invasive approach for the same with the added advantage of better cosmesis. We have developed and standardised the SILS approach at our institute. We share our experience and technical “tips” and modifications which we have learnt over the years. Technical details of performing sleeve gastrectomy and Roux-en-Y gastric bypass with special attention to liver retraction, techniques of dissection in difficult areas, creation of anastomoses and suturing have all been described. In our experience and in experience of others, single-incision bariatric surgery is feasible. Use of conventional laparoscopic instruments makes single-incision approach practical for day-to-day practice. Supervised training is essential to learn these techniques.