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Technical Feasibility, Outcomes, and Patient Satisfaction After Needlescopic and Laparoscopic Bariatric Surgery: a Randomized Study

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Abstract

Background

Needlescopic instruments create a 3-mm incision and may result in less pain and superior cosmesis. There is limited understanding of the effectiveness of needlescopic instruments in patients with a body mass index (BMI) > 35 kg/m2. We report perioperative outcomes and perception of body image with use of needlescopic instruments after bariatric surgery.

Methods

Laparoscopic bariatric procedures were performed on 30 adults at a single academic medical center from January to December 2017. Patients were randomized to conventional laparoscopy (LAP) or needlescopic (NEED) surgery. The Multidimensional Body-Self Relations Questionnaire (MBSRQ) and Patient Scar Assessment Questionnaire (PSAQ) were completed at 6 months and 1 year. Univariate analysis was performed on perioperative outcomes and survey scores.

Results

Surgery was completed on patients in the LAP group (N = 13) and compared to the NEED group (N = 17). The mean BMI was 41.4 kg/m2 LAP and 41.1 kg/m2 NEED. The most common procedure was Roux-en-Y gastric bypass (RYGB), with 13 RYGB in LAP and 12 RYGB in NEED (P = 0.76).The operative time was not significantly different between the LAP and the NEED group (209.5 ± 66.1 vs 181.9 ± 58.1 min, P = 0.48). There was no leak or mortality in the 30-day follow-up period. Within MBSRQ, the patient’s appearance self-evaluation score was similar between LAP and NEED (2.5 ± 0.6 vs 2.4 ± 0.6, P = 0.61). Within PSAQ, the mean satisfaction score for incision appearance was also similar between LAP and NEED (16.1± 2.9 vs 15.4 ± 4.6, P = 0.85). Incision-related perceptions remained consistent at 6 months and 1 year after bariatric surgery.

Conclusions

Needlescopic instruments are safe and a viable alternative to use during bariatric surgery. Appearance and perception of scar were similar between groups. Further studies with needlescopic instruments should include patients with a BMI > 35 kg/m2 and compare additional factors associated with body image.

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Funding

This study was sponsored by Teleflex Incorporated (Wayne, PA).

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Authors and Affiliations

  1. School of Medicine, Department of Surgery, Duke University, 407 Crutchfield St, Durham, NC, 27704, USA

    Yen-Yi Juo, Chan Park, Jin Yoo, Daniel Guerron, Ranjan Sudan, Dana Portenier & Keri A. Seymour

  2. Department of Psychiatry, Duke University Medical Center, Durham, NC, 27704, USA

    Kelli Friedman

Authors
  1. Yen-Yi Juo
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  2. Chan Park
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  3. Jin Yoo
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  4. Daniel Guerron
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  5. Ranjan Sudan
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  6. Kelli Friedman
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  7. Dana Portenier
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  8. Keri A. Seymour
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Corresponding author

Correspondence to Keri A. Seymour.

Ethics declarations

Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent to Participate

Informed consent was obtained from all individual participants prior to inclusion in the study.

Conflict of Interest

Authors CP, JY, DG, RS, and DP were consultants to Medtronic, Gore, Intuitive. The other authors have no conflicts of interest to declare.

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Key Points

1. Percutaneous instruments are needlescopic instruments with thinner shafts that forego the need for trocars.

2. The use of needlescopic instruments is feasible and safe during bariatric procedures for patients with morbid obesity.

3. Patient satisfaction with cosmetic outcome and preoccupation of weight were similar after bariatric procedures performed with needlescopic instruments or conventional laparoscopy.

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Juo, YY., Park, C., Yoo, J. et al. Technical Feasibility, Outcomes, and Patient Satisfaction After Needlescopic and Laparoscopic Bariatric Surgery: a Randomized Study. OBES SURG 31, 5085–5091 (2021). https://doi.org/10.1007/s11695-021-05675-5

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  • DOI: https://doi.org/10.1007/s11695-021-05675-5

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