How many holes are used for sleeve gastrectomy ?
How many holes are used for sleeve gastrectomy ? 3? 4? 5? Which one should it be?
One of the questions frequently asked by our patients who decide to have sleeve gastrectomy or gastric bypass surgery is whether the surgery will be performed open or closed or how many holes will be performed. These surgeries are performed closed or keyhole unless there is an extra condition. Sleeve gastrectomy is performed with 5 holes as standard. The first of these holes is about 1-1.5 cm in diameter above the umbilicus where the camera is inserted.
The second hole is under the right rib of the patient, 4-5 cm to the right of the midline of the abdomen, approximately 1-1.5 cm wide hand tools and a device called stapler that stitches and cuts the stomach. The third hole is entered 4-5 cm left of the midline and just below the left rib line. The instruments used in surgery enter through this hole and the resected stomach, after sleeve gastrectomy done, is removed from here. The 4th hole is the hole a few cm below and to the left of this hole, which is used by the asistant, 0.5 cm in diameter, and which is used to retract the stomach aside to cut it more properly and in sufficient amount, especially for sleeve gastrectomy. The 5th hole is the hole used on the midline of the abdomen just below the rib cage to retract the 0.5 cm liver from the operation area. The first 3 of these holes are mandatory to use (1,2,3). Gastric sleeve surgery can be performed without the 4th and 5th holes. However, in this case, it is difficult to retract the liver from the operation area, especially in people with a large liver, and it is also not possible to retract the stomach while mobilizing fundus and cutting it. This makes difficult to cut the stomach in a standard, proper and adequate manner. Therefore, the absence of these 2 holes prolongs the operation time and causes additional difficulties for the surgeon.
This may impair the quality of the surgery. For example, the stomach may be curved, not cut enough. For this reason, performing the surgery through 5 holes is both safer and prevents completion of the surgery in a short time and thus prolonging the duration of anesthesia. This reduces complications such as atelectasis, embolism, or clotting which can be seen after sleeve gastrectomy. I share this thinking that it is important for you, people wants to get the gastric sleeve, to know that. With my best wishes, sincerely
Prof Dr M. TAHİR ORUÇ
+90 555 1920732