The Left Subcostal Incision Revisited

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Since 1979, this author has used exclusively a left subcostal incision for gastroplasty (GP) and Roux-en-Y gastric bypass (RYGBP), with complication rates better than published reports in the literature for midline incisions. Methods and


From July 1979 through March 1997, 1798 primary GP and RYGBP procedures have been done through the left subcostal incision, in addition to 42 conversions of GP to RYGBP, for a total of 1840 new left subcostal incisions. Comparison with an earlier series revealed no significant changes in results: incision hernias three (0.16%), dehiscence four (0.2%), splenectomy three (0.16%). No splenectomies have been necessary since 1983. Various wound healing problems occurred rarely (2.2%). Conclusion: The author believes that the left subcostal incision should be the gold-standard of bariatric surgery open procedures.

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