Scarless Bariatric Surgery

Abstract

Background: Conventional laparoscopic technique requires five to seven abdominal incisions for the placement of multiple trocars. Recently concept of “No scar surgery” is quickly expanding in weight loss surgery. In bariatric surgeries, the SILS technique has been employed to perform adjustable banding, sleeve gastrectomy, Roux-en-Y gastric bypass and biliopancreatic diversion procedures. Method: Transumbilical incsion is used for access in scarlesss sleeve gastrectomy. The surgical technique involved is identical to that of conventional laparoscopic sleeve gastrectomy. It starts by mobilizing the greater curvature starting 4-6-cm from the pylorus till the angle of His. A vertical gastrectomy is then performed with endoscopic staplers followed by imbrication of staple line. Results: Single-incision laparoscopic sleeve gastrectomy was associated with less postoperative pain, a lower need for analgesics and a decreased length of hospital stay compared to the conventional multi-port technique. The surgical scar is almost completely hidden within the umbilicus. Most surgeons do not recommend this procedure for those with a BMI greater than 50 kg/m2. and should be avoided in tall patients (height >180 cm). Conclusion: Scarless bariatric surgery is a new unavoidable trend because of concern about the privacy and quality of life. It has been shown to be a technically more feasible and reproducible procedure for a select group of morbidly obese patients. As this procedure requires far more skill than a conventional multiport surgery, it should be undertaken by experienced bariatric surgeons.