The "Tip-Stitch": A Time-Saving Technique for Specimen Extraction in Sleeve Gastrectomy

Laparoscopic sleeve gastrectomy has gained popularity as another tool available to weight loss surgeons, with published excess weight loss results similar or superior to laparoscopic adjustable gastric banding. The gastrectomy specimen consists of a hollow "bag" of fundus, which is typically extracted through an enlarged port site. Extraction can be a challenging and time-consuming portion of the operation. The "Tip-Stitch" is a low-technology method of orienting the gastric specimen for easy retrieval. A suture through the distal tip of the specimen allows for extraction without enlarging a 15-mm trocar site. We report a small series of sleeve gastrectomy using this specimen extraction technique. No wound infections were seen, and enlargement of the fascial incision was done only once, early in our experience. Our technique describes a reliable method of intact specimen retrieval, typically without enlarging a 15-mm trocar incision.