Multi-Purpose Dynamic Use of Right Subcostal Trocar in Laparoscopic Sleeve Gastrectomy: Retrospective Analysis of a Single Center Experience

Abstract

Objective: It is important to prevent exploration difficulties caused by the presence of fat and hypertrophic liver in obese patients and provide a good surgical field of vision. Recently, various liver retraction techniques have been described for laparoscopic procedures. We aimed to assess outcomes of a multi-purpose dynamic use of right subcostal trocar in laparoscopic sleeve gastrectomy. Method: All patients who underwent laparoscopic sleeve gastrectomy from January 2016 to December 2017 were determined prospectively. The data were retrospectively reviewed. Results: Five hundred and seventy-six patients were included in the study. Average age was 38.9 years, average body weight 130.8 kg and average body mass index (BMI) 47.4 kg/m(2). Complications such as bleeding, leakage and stenosis were observed in 6,7 and 6 patients, respectively. There were no significant change of the serum liver enzymes in both preoperative and postoperative periods. No additional retractor was required for liver retraction in any of the cases. None of our patients experienced any complications related to the methods described in the perioperative period. Conclusion: Right subcostal trocar in laparoscopic sleeve gastrectomy for liver retraction can be successfully used without risks of postoperative morbidity and clear inspection of the surgical field with traction of the respective area. There is a need for long-term outcomes.