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    • The Laparo-endoscopic Rendezvous: An Evolving Technique in Sleeve Gastrectomy

    Ayman M. A. Osman1, Mohamed D. Sarhan1, Doaa A. Mansour1, Mohamed H. A. Fahmy1, Mohamed S. Abdel-Bary2, Mostafa Abdelaziz1
    1Department of General Surgery, Faculty of Medicine, Cairo University, Egypt. 2Department of Tropical Medicine, Faculty of Medicine, Cairo University, Egypt

    Objective: Laparoscopic sleeve gastrectomy (LSG) is a relatively new bariatric surgical procedure that is commonly performed nowadays. Here, we conducted a prospective study in order to evaluate the potential benefits and drawbacks of the use of intra-operative endoscopy (IOE) in conjunction with LSG, which we called the “Laparo-endoscopic Rendezvous” technique. Methodology: Fifteen morbidly obese patients underwent LSG using the "Laparo-endoscopic Rendezvous" technique. The potential benefits of this technique, difficulties encountered, as well as operative time and postoperative complications were observed. Results: Three intra-operative problems were encountered in our study group [intra-luminal bleeding (n=1), twisting of the gastric sleeve (n=1), kinking of the gastric sleeve (n=1)]. The operative time ranged from 100 to 180 minutes (mean, 134.3 ± 21.86 SD). No postoperative complications were reported and the gastric leak rate was 0%. Conclusion: Inspite of the logistical and technical difficulties encountered, and the relatively long operative time, the "Laparo-endoscopic Rendezvous” is a safe and promising technique with several potential benefits. It allows for assessment of the staple-line integrity by different methods and for intra-operative detection and management of some potential LSG problems, thereby preventing postoperative morbidity. Keywords: Intraoperative endoscopy; Laparo-endoscopic; Rendezvous technique; Laparoscopic sleeve gastrectomy; Morbid obesity. 

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