Background

Laparoscopic Omega Loop bypass (LOLB) has proven to be a safe and successful bariatric procedure. Typically, the procedure is performed using five to seven trocars. The urge to minimize surgical trauma and pain has led to the development of reduced trocars procedure, which has been shown to be a safe and less- invasive. To assess the safety and feasibility of 3-Trocars LOLB procedure.

Methods

526 patients underwent 3 trocars LOLB between February 2011 and January 2019. The same surgeon performed all procedures. The umbilicus was the point of optical port for all patients with a 5mm trocar and the same operative technique and perioperative protocol were used in all patients. Data were added to a previous study from the same department. Data included operative time, subjective pain scores, length of stay, operative complications. Data regarding excess weight loss were collected after 1 year follow-up. The parameters were compared to 529 patients who had 5 to 7 trocars technique in the same time period.

Results

A total of 526 triple-incision LOLB procedures were performed. The procedures were successfully performed in all patients. Mean operating time was 63 minutes. One patient required conversion to laparotomy, two patients leaked and required reoperation, one patient developed a pelvic abscess one week postoperatively and 3 patients dropped hemoglobin and required blood transfusion. There were no mortalities.

Conclusions

Three trocar laparoscopic omega loop bypass is safe, technically feasible and reproducible. Operative time was acceptable and post-operative recovery and complications were comparable to 5-7 trocars technique