A New Method in Laparoscopic Sleeve Gastrectomy: Reverse Trendelenburg with Right Lateral Tilt Position Prior to Trocar Entry
Okay Koç, İbrahim Tayfun Şahiner, Feza Ekiz
Gastroenterology Surgery Service, Aydın State Hospital, Aydın, Turkey
Med Sci Monit 2017; 23:4513-4517
The primary aim of this study was to evaluate the effectiveness of patient positioning prior to trocar entry in laparoscopic sleeve gastrectomy.
MATERIAL AND METHODS: The records of 300 patients that had a laparoscopic sleeve gastrectomy surgery at Aydin State Hospital from January 2015 until January 2017 were analyzed retrospectively. First, 140 patients who had been placed in the surgical position after the entry of trocars (PAET) were included as the first group, and 160 patients who had been placed in the surgical position before entry of trocars (PBET) were included as the second group. A comprehensive analysis based on the comparison of age, gender, body mass index (BMI), duration of total anesthesia, and incompleteness rate of operations between the two groups was performed.
RESULTS: The PAET group was composed of 111 females (79.3%) and 29 males (20.7%). The averages of age, BMI, and duration of anesthesia for this group were 36.84, 46.3 kg/m², and 161.56 minutes, respectively. The PBET group was composed of 123 females (76.9%) and 37 males (23.1%). The averages of age, BMI, and duration of anesthesia of this second group were 38.8, 47.4 kg/m², and 120.8 minutes, respectively. In the PAET group, the operations for four patients (2.9%) were never completed; in the PBET group, there was no uncompleted operations (p=0.046).
CONCLUSIONS: PBET is an effective method which both shortens the operation time and decreases the rate of uncompleted operations.
Keywords: Bariatric Surgery, Gastrectomy, Head-Down Tilt, Laparoscopy, Obesity, Abdominal