A comparative analysis of the liver retraction with long surgical gauze in three-port sleeve gastrectomy and the four-port nathanson retractor technique
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Dosyalar
Tarih
2025
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Background: This study evaluated the long surgical gauze (SurG) technique as a liver retraction method in laparoscopic sleeve gastrectomy (LSG). Traditional methods involve the Nathanson retractor, associated with ischemia and necrosis complications. In addition, these techniques require an additional trocar with an incision that increases postoperative pain. Our aim, therefore, was to reduce such complications through the use of SurG and evaluate recovery and outcome implications.
Methods: In this retrospective study, patients who underwent laparoscopic sleeve gastrectomy (LSG) between January and December 2023 were divided into two groups based on the liver retraction method used: NR or SurG. Demographic data, surgery times, postoperative liver enzyme levels (AST, ALT), C-reactive protein (CRP), pain scores, and analgesic use (VAS) were collected from medical records and statistically analyzed.
Results: The SurG group demonstrated significantly lower postoperative pain scores and reduced analgesic use compared to the NR group (p < 0.001). Additionally, liver enzyme levels (AST, ALT, CRP) were lower in the SurG group, indicating less liver stress. Early mobilization was achieved more quickly in the SurG group, aligning with Enhanced Recovery After Surgery (ERAS) protocols. However, the SurG method showed some limitations during the dissection of the greater curvature due to the narrower field of view.
Conclusions: The long surgical gauze method provides a viable alternative to the Nathanson retractor, offering advantages such as less postoperative pain, reduced liver stress, and quicker mobilization. Despite some technical limitations, this method can improve patient outcomes in sleeve gastrectomy.
Açıklama
Anahtar Kelimeler
ERAS, Liver enzymes, Liver retraction, Long surgical gauze, Obesity surgery
Kaynak
Obesity Surgery
WoS Q Değeri
Q1
Scopus Q Değeri
Q1
Cilt
Sayı
Künye
Ertekin, S. Ç., Önsal, U., Turgut, E., Akyol, H., Ünver, M., Demirpolat, M. T., Akbulut, G. (2025). A comparative analysis of the liver retraction with long surgical gauze in three-port sleeve gastrectomy and the four-port nathanson retractor technique. Obesity Surgery. 10.1007/s11695-024-07663-x
