Advantage of ultramicro-invasive surgical instruments in laparoscopic sleeve gastric surgery

Objective: To investigate the safety and effectiveness of ultra-minimally invasive surgical instruments in laparoscopic sleeve gastrectomy (LSG). Methods A total of 134 patients, including 67 patients who underwent 4-hole LSG, 29 patients who underwent 3-hole LSG, and 38 patients who underwent ultra-minimally invasive laparoscopic sleeve gastrectomy (ULSG), from July 2018 to December 2022 were included in this study. The operation times, bleeding volumes, and pain scores among the three groups (4-hole LSG group, 3-hole LSG group, ULSG group) were compared. Results The bleeding volumes in the 4-hole LSG group, 3-hole LSG group, and ULSG group were 6.6 ± 5.1 ml, 10.0 ± 4.9 ml, and 5.6 ± 3.3 ml, respectively. The operation times in the 4-hole LSG group, 3-hole LSG group, and ULSG group were 103.8 ± 21.3 min, 122.9 ml ± 24.0 min, and 110.7 ± 30.0 min, respectively. The pain scores in the 4-hole LSG group, 3-hole LSG group, and ULSG group were 5.0 ± 2.0, 4.0 ± 1.5, and 3.9 ± 1.6, respectively. However, one case each of gastric leakage (1.49%), gastric stenosis (3.45%), and severe vomiting (2.63%) were reported in the 4-hole LSG, 3-hole LSG group, and ULSG group, respectively (P = 0.909). Conclusion Ultra-minimally invasive instrument-assisted LSG (ULSG) is a safe and convenient operation that enhances skin beauty. Besides, the method of picking, blocking, and pulling can better expose the visual field and cut the gastric tissue.