A comparative analysis of the liver retraction with long surgical gauze in three-port sleeve gastrectomy and the four-port nathanson retractor technique

dc.contributor.authorErtekin, Süleyman Çağlar
dc.contributor.authorÖnsal, Ufuk
dc.contributor.authorTurgut, Emre
dc.contributor.authorAkyol, Hüseyin
dc.contributor.authorÜnver, Mutlu
dc.contributor.authorDemirpolat, Muhammed Taha
dc.contributor.authorAkbulut, Gökhan
dc.date.accessioned2025-01-15T07:34:14Z
dc.date.available2025-01-15T07:34:14Z
dc.date.issued2025en_US
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü,Genel Cerrahi Ana Bilim Dalıen_US
dc.description.abstractBackground: 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.en_US
dc.identifier.citationErtekin, 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-xen_US
dc.identifier.issn0960-8923
dc.identifier.issn1708-0428
dc.identifier.pmid39775390
dc.identifier.scopus2-s2.0-85214218711
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://hdl.handle.net/20.500.12939/5150
dc.identifier.wosWOS:001392453500001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorErtekin, Süleyman Çağlar
dc.language.isoen
dc.relation.ispartofObesity Surgery
dc.relation.isversionof10.1007/s11695-024-07663-xen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectERASen_US
dc.subjectLiver enzymesen_US
dc.subjectLiver retractionen_US
dc.subjectLong surgical gauzeen_US
dc.subjectObesity surgeryen_US
dc.titleA comparative analysis of the liver retraction with long surgical gauze in three-port sleeve gastrectomy and the four-port nathanson retractor technique
dc.typeArticle

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