Abstract

Abstract
Background
Laparoscopic sleeve gastrectomy (LSG) is a surgical surgery in which a substantial part of the stomach is removed to restrict food intake and facilitate weight loss. It is less expensive than other weight-loss operations like gastric bypass. Individuals with a BMI greater than 40 kg/m2 or a BMI greater than 35 kg/m2 with comorbidities who have failed to achieve and sustain weight loss by non-surgical techniques might consider LSG.

Objective
The objective of this study is to compare the efficacy and safety of The four-port technique in LSG in terms of improved visualization, reduced risk of incidental injuries to other organs, and fewer technical challenges. The shorter operative time and simpler surgical setup make LSG more cost-effective than other weight-loss procedures.

Methods
The study involved 150 patients aged 18–45 years with a BMI between 35 and 50. The laparoscopic sleeve gastrectomy procedure was performed using a four-port technique, using four trocars to puncture the abdominal wall and access the surgical site.

Results
The study found that Laparoscopic sleeve gastrectomy using a four-port technique was successful in 94.6% of cases, with only 3.3% requiring extra ports. The procedure was relatively short, with a median operating time of 55 minutes. Postoperatively, complications were low, with intraabdominal bleeding, staple-line leaks, and port site hernias being the most common.

Conclusion
Our recommendation is to perform a 4-port laparoscopic sleeve gastrectomy in all patients with a body mass index of less than 50 kg/m2, and if there is any struggle during the procedure, we can add more ports at any time.