Background

The aim of this study was to evaluate the feasibility and safety of laparoscopic 3-port sleeve gastrectomy in morbidly obese patients. We conducted a retrospective review of the electronic medical records of all patients who underwent laparoscopic 3-port sleeve gastrectomy (LSG-3) and conventional 4-port sleeve gastrectomy (LSG-4) between May 2021 and May 2022 at a single institution. Operative time, estimated blood loss, number of cartridges used, length of postoperative hospital stay, intra- and postoperative complications, readmission, and reoperation rate was assessed. Sixty-eight patients (31 patients undergoing LSG-3 and 37 patients undergoing LSG-4 were enrolled in this study. Body weight and BMI was significantly higher in LSG-4 group than in LSG-3 group, respectively (123.0±29.4 vs. 104.3±20.2kg, p=0.003 and 43.8±9.3 vs. 37.8±7.2, p=0.004). Operative time was significantly shorter in LSG-3 group than LSG-4 group (108.7±17.8 vs. 120.8±23.7, p=0.023). Estimated blood loss and number of cartridges used is not significant between two groups (16.1±17.8ml and 5.8±0.8 in LSG-4 vs. 12.1±11.5ml and 5.5±0.6 in LSG-3). The length of postoperative stay was significantly shorter in LSG-4 than LSG-3 (2.4±0.6 vs. 2.9±1.2, p=0.034). there was no difference between two groups in terms of intra- and postoperative complications, readmission, and reoperation rate. Only 1 case in LSG-3 group was reoperated due to postoperative bleeding. 4 cases were converted LSG-3 to LSG-4 for liver traction (2 cases), better vision (1 case), and bleeding control (1 case). LSG-3 is feasible and safe in Asian morbidly obese patients.