Bariatric Surgery Clinical Trial
Official title:
Impact of the Systematic Closure of the Epigastric Trocar on Postoperative Incisional Hernia After Sleeve Gastrectomy Rate of First Intention. Monocentric Study, Before / After Prospective.
The Sleeve Gastrectomy (SG) is a bariatric surgery procedure performed by laparoscopic
booming in recent years.
This is an effective intervention on weight loss over the long term with few early
postoperative complications and low morbidity in the long term.
Obesity is considered as a risk factor for hernia full after surgery by laparoscopy with a
relative risk of 29% in connection with cholecystectomy.
Several series showed a rupture rate on trocar from 0 to 0.7%, but each time with a clinical
evaluation.
Recently, it was shown eventrations rate between 26 and 38% under the Roux-en-Y gastric
bypass with a rupture rate increased on epigastric trocar. The assessment in the context of
this series was ultrasound.
Recent data suggest that the absence of closure of the epigastric trocar of 12mm through an
SG of first intention was associated with a hernia rate of 17% with a scannographic
evaluation.
Also, recently, Tabone suggests that the systematic closure of the epigastric trocar site
would not be as effective as lateralize inserting the trocar from the white line of the
abdomen. Change the positioning of this trocar induce an additional difficulty in handling
instruments for the realization of the SG with an désaxassion instruments, a conflict between
the instruments for the realization of the SG and the optical laparoscopy.
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