Intraabdominal partitioning of the laparoscopic sleeve gastrectomy remnant optimizes the specimen extraction ergonomics and postoperative pain and is an attractive technique in teenage patients.

Overview

INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) has become an increasingly popular bariatric procedure in the pediatric population worldwide. The fear of complications, postoperative pain, and recovery remain the reservations for wider application of surgery in morbidly obese children. We present a novel technique for LSG remnant retrieval. MATERIALS AND METHODS: The patient was a 16-year old girl with a body mass index of 55 kg/m(2) and significant comorbidities who underwent LSG and liver biopsy. In the extraction technique, a specimen containing the gastric body and fundus, approximately 80% of the stomach volume, was partitioned longitudinally and intracorporeally with endoshears; subsequently, it was retrieved in one fragment via the lumen of a 15-mm port. RESULTS: The procedure time was 65 minutes (specimen extraction time was 7 minutes). Her recovery was uneventful, and she was discharged home on the second postoperative day. At the 1-, 3-, and 6-month follow-up, she has shown all the benefits of weight loss and associated improvement in metabolic parameters and quality of life, without any complications. CONCLUSIONS: This technique for gastric remnant retrieval results in minimizing postoperative pain, reducing operative costs, and minimizing the likelihood of wound infection.