# Single-Port One Anastomosis Sleeve Gastrectomy with Transit Bipartition: Initial Experience and Technique

## TL;DR

This paper presents initial experience with a new single-port sleeve gastrectomy technique that may improve diabetes and reflux outcomes.

## Contribution

The novel contribution is the application of a single-port approach to the one anastomosis transit bipartition sleeve gastrectomy procedure.

## Key findings

- Single-port SG-OATB was feasible and safe in three patients with no 30-day readmissions.
- The most technically challenging part was closing the anastomosis defect.
- Procedure duration averaged 170 minutes with no need to convert to multiple-port surgery.

## Abstract

Sleeve gastrectomy with transit bipartition (SG-TB) procedure has been gaining traction recently. While being a relatively novel procedure, it shows potentials to improve the standalone SG outcomes, such as diabetes remission and reflux. This article aims to show insights on performing SG-TB in one anastomosis fashion (SG-OATB) and single-port approach.

Three patients who underwent laparoscopic single-port SG-OATB at our hospital were included. The parameters included in this study comprised of age, gender, height, weight, body mass index (BMI), type 2 diabetes mellitus (T2DM) assessment, gastroesophageal reflux disease (GERD) assessment, length of the small bowel, the duration of the procedure, and 30-day readmission rate.

The mean preoperative assessments for the three patients were as follows: two females vs. one male; age 38.7 ± 5.5 years old; weight 105.7 ± 5.4 kg; height 1.64 ± 0.11 m; BMI 39.3 ± 4.7 kg/m2; fasting blood glucose 6.7 ± 1.2 mmol/L; glycosylated hemoglobin level 7.1 ± 1.3%; GERD-Questionnaire score 6.3 ± 1.5; two patients with esophagitis grade A and B following endoscopy. The total duration of the procedure was 170.0 ± 26.5 min; there was no need for conversion to multiple-port in all patients. The 30-day readmission rate for all patients was 0%.

In our small cases of patients, single-port SG-OATB is feasible and safe. We found the closure of the anastomosis defect to be most technically demanding. To understand better the outcome of single-port SG-OATB, studies with larger sample and longer follow-up will be needed in the future.

The online version contains supplementary material available at 10.1007/s11695-024-07295-1.