Skip to main content

Advertisement

SpringerLink
Log in

Efficacy of Tight Sleeve Gastrectomy in Superobesity: Single Surgeon Experience

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Sleeve gastrectomy is performed more than any other surgery for obesity. Tight sleeve gastrectomy involves extensive posterior dissection of the stomach and use of a smaller size bougie. Superobese individuals have a body mass index greater 50 kg/m2. The success of sleeve gastrectomy in superobese patients was argued in medical literature before and different conclusions were reached. In this article, we are presenting outcomes of single surgeon experience utilizing tight sleeve gastrectomy for the treatment of superobesity. The follow-up data of 345 patients who had primary laparoscopic tight sleeve gastrectomy performed by the same surgeon between 2011 and 2019 were analyzed. Mean percent excess weight loss was 67.75 SD18.93 and mean total weight loss was 37.42 SD9.8 at a mean follow-up interval of 18.77 SD13.21 months. When percent excess weight loss of superobese group was compared with non-superobese group, the difference was not statistically significant. There was a significant improvement in all co-morbidities. Tight sleeve gastrectomy is a safe and efficacious technique for weight loss and treatment of co-morbidities in superobese individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. No authors listed (1992) Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference Statement. Am J Clin Nutr 55(2 Suppl):615S-619S. https://doi.org/10.1093/ajcn/55.2.615s

    Article  Google Scholar 

  2. van de Laar A, de Caluwé L, Dillemans B. (2011) Relative outcome measures for bariatric surgery. Evidence against excess weight loss and excess body mass indexloss from a series of laparoscopic Roux-en-Y gastric bypass patients. Obes Surg. 21(6):763–7. https://doi.org/10.1007/s11695-010-0347-0

  3. Singh A, Koenen B, Kirby DF.(2020) Bariatric surgery and its complications in inflammatory bowel disease patients. Inflamm Bowel Dis. 17;26(8):1155–1165. https://doi.org/10.1093/ibd/izz246.

  4. Aminian A (2020) Roux-en-Y gastric bypass or sleeve gastrectomy for type 2 diabetes: expanding role of individualized metabolic surgery score. Surg Obes Relat Dis 16(7):972–973. https://doi.org/10.1016/j.soard.2020.03.027

    Article  PubMed  Google Scholar 

  5. Skrekas G, Lapatsanis D, Stafyla V, Papalambros A (2008) One year after laparoscopic “tight” sleeve gastrectomy: technique and outcome. Obes Surg 18(7):810–813. https://doi.org/10.1007/s11695-008-9440-z

    Article  PubMed  Google Scholar 

  6. Nguyen NT, Nguyen B, Gebhart A, Hohmann S (2013) Changes in the makeup of bariatric surgery: a national increase in use of laparoscopic sleeve gastrectomy. J Am Coll Surg 216(2):252–257. https://doi.org/10.1016/j.jamcollsurg.2012.10.003

    Article  PubMed  Google Scholar 

  7. Roa PE, Kaidar-Person O, Pinto D, Cho M, Szomstein S, Rosenthal RJ (2006) Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obes Surg 16(10):1323–1326. https://doi.org/10.1381/096089206778663869

    Article  PubMed  Google Scholar 

  8. Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, Gfrerer L, Ludvik B, Zacherl J, Prager G (2010) Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg 20(5):535–540. https://doi.org/10.1007/s11695-009-0066-6

    Article  PubMed  Google Scholar 

  9. Brethauer SA, Kim J, el Chaar M, Papasavas P, Eisenberg D, Rogers A, Ballem N, Kligman M, Kothari S, Clinical Issues ASMBS, Committee. (2015) Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis 11(3):489–506. https://doi.org/10.1016/j.soard.2015.02.003

    Article  PubMed  Google Scholar 

  10. Billing P, Billing J, Harris E, Kaufman J, Landerholm R, Stewart K (2019) Safety and efficacy of outpatient sleeve gastrectomy: 2534 cases performed in a single free-standing ambulatory surgical center. Surg Obes Relat Dis 15(6):832–836. https://doi.org/10.1016/j.soard.2019.03.003

    Article  PubMed  Google Scholar 

  11. Morgan DJR, Platell C, Ho KM (2020) The incidence and determinants of bariatric reoperations: a population-based cohort study. Surg Obes Relat Dis 16(5):663–669. https://doi.org/10.1016/j.soard.2020.01.015

    Article  PubMed  Google Scholar 

  12. Daousi C, Casson IF, Gill GV, MacFarlane IA, Wilding JP, Pinkney JH (2006) Prevalence of obesity in type 2 diabetes in secondary care: association with cardiovascular risk factors. Postgrad Med J 82(966):280–284. https://doi.org/10.1136/pmj.2005.039032

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Holst JJ, Madsbad S, Bojsen-Møller KN, Svane MS, Jørgensen NB, Dirksen C, Martinussen C (2018) Mechanisms in bariatric surgery: gut hormones, diabetes resolution, and weight loss. Surg Obes Relat Dis 14(5):708–714. https://doi.org/10.1016/j.soard.2018.03.003

    Article  PubMed  PubMed Central  Google Scholar 

  14. Nocca D, Guillaume F, Noel P, Picot MC, Aggarwal R, El Kamel M, Schaub R, de Seguin de Hons C, Renard E, Fabre JM.(2011) Impact of laparoscopic sleeve gastrectomy and laparoscopic gastric bypass on HbA1c blood level and pharmacological treatment of type 2 diabetes mellitus in severe or morbidly obese patients. Results of a multicenter prospective study at 1 year. Obes Surg.21(6):738–43. https://doi.org/10.1007/s11695-011-0385-2.

  15. Narkiewicz K. Obesity and hypertension--the issue is more complex than we thought.(2006) Nephrol Dial Transplant.21(2):264–7. https://doi.org/10.1093/ndt/gfi290.

  16. Aronow WS.(2017) Association of obesity with hypertension. Ann Transl Med.5(17):350. https://doi.org/10.21037/atm.2017.06.69.

  17. Sarkhosh K, Birch DW, Shi X, Gill RS, Karmali S (2012) The impact of sleeve gastrectomy on hypertension: a systematic review. Obes Surg 22(5):832–837. https://doi.org/10.1007/s11695-012-0615-2

    Article  PubMed  Google Scholar 

  18. Bays HE, Toth PP, Kris-Etherton PM, Abate N, Aronne LJ, Brown WV, Gonzalez-Campoy JM, Jones SR, Kumar R, La Forge R, Samuel VT (2013) Obesity, adiposity, and dyslipidemia: a consensus statement from the National Lipid Association. J Clin Lipidol 7(4):304–383. https://doi.org/10.1016/j.jacl.2013.04.001

    Article  PubMed  Google Scholar 

  19. Jenkins DJ, Kendall CW, Vidgen E, Augustin LS, van Erk M, Geelen A, Parker T, Faulkner D, Vuksan V, Josse RG, Leiter LA, Connelly PW (2001) High-protein diets in hyperlipidemia: effect of wheat gluten on serum lipids, uric acid, and renal function. Am J Clin Nutr 74(1):57–63. https://doi.org/10.1093/ajcn/74.1.57

    Article  CAS  PubMed  Google Scholar 

  20. Frezza EE, Reddy S, Gee LL, Wachtel MS (2009) Complications after sleeve gastrectomy for morbid obesity. Obes Surg 19(6):684–687. https://doi.org/10.1007/s11695-008-9677-6

    Article  PubMed  Google Scholar 

  21. Sethi M, Zagzag J, Patel K, Magrath M, Somoza E, Parikh MS, Saunders JK, Ude-Welcome A, Schwack BF, Kurian MS, Fielding GA, Ren-Fielding CJ (2016) Intraoperative leak testing has no correlation with leak after laparoscopic sleeve gastrectomy. Surg Endosc 30(3):883–891. https://doi.org/10.1007/s00464-015-4286-7

    Article  PubMed  Google Scholar 

  22. Lopez PP, Stefan B, Schulman CI, Byers PM (2008) Prevalence of sleep apnea in morbidly obese patients who presented for weight loss surgery evaluation: more evidence for routine screening for obstructive sleep apnea before weight loss surgery. Am Surg 74(9):834–838

    Article  PubMed  Google Scholar 

  23. Cottam DR, Mattar SG, Barinas-Mitchell E, Eid G, Kuller L, Kelley DE, Schauer PR (2004) The chronic inflammatory hypothesis for the morbidity associated with morbid obesity: implications and effects of weight loss. Obes Surg 14(5):589–600. https://doi.org/10.1381/096089204323093345

    Article  PubMed  Google Scholar 

  24. Yildiz BD (2016) Rapid remission of psoriasis after sleeve gastrectomy. Indian J Surg 78(1):60–62. https://doi.org/10.1007/s12262-015-1350-4

    Article  PubMed  Google Scholar 

  25. Gadiot RP, Biter LU, Zengerink HJ, de Vos tot Nederveen Cappel RJ, Elte JW, Castro Cabezas M, Mannaerts GH. (2012) Laparoscopic sleeve gastrectomy with an extensive posterior mobilization: technique and preliminary results. Obes Surg 22(2):320–329. https://doi.org/10.1007/s11695-011-0488-9

    Article  PubMed  Google Scholar 

  26. Sisik A, Basak F (2020) Presurgical predictive factors of excess weight loss after laparoscopic sleeve gastrectomy. Obes Surg 30(8):2905–2912. https://doi.org/10.1007/s11695-020-04624-y

    Article  PubMed  Google Scholar 

  27. Le Foll D, Lechaux D, Rascle O, Cabagno G (2020) Weight loss and quality of life after bariatric surgery: a 2-year longitudinal study. Surg Obes Relat Dis 16(1):56–64. https://doi.org/10.1016/j.soard.2019.10.010

    Article  PubMed  Google Scholar 

  28. Basso N, Casella G, Rizzello M, Abbatini F, Soricelli E, Alessandri G, Maglio C, Fantini A (2011) Laparoscopic sleeve gastrectomy as first stage or definitive intent in 300 consecutive cases. Surg Endosc 25(2):444–449. https://doi.org/10.1007/s00464-010-1187-7

    Article  CAS  PubMed  Google Scholar 

  29. Mocanu V, Dang J, Ladak F, Switzer N, Birch DW, Karmali S (2019) Predictors and outcomes of bleed after sleeve gastrectomy: an analysis of the MBSAQIP data registry. Surg Obes Relat Dis 15(10):1675–1681. https://doi.org/10.1016/j.soard.2019.07.017

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. General Surgery Department, Ankara Numune Teaching Hospital, Bestekar sok. 6/10 Kavaklidere, Ankara, 06680, Turkey

    Baris Dogu Yildiz

  2. General Surgery Department, Yenimahalle Teaching Hospital, Ankara, Turkey

    Mustafa Alimoğullari

Authors
  1. Baris Dogu Yildiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mustafa Alimoğullari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Baris Dogu Yildiz.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yildiz, B.D., Alimoğullari, M. Efficacy of Tight Sleeve Gastrectomy in Superobesity: Single Surgeon Experience. Indian J Surg (2022). https://doi.org/10.1007/s12262-021-03227-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12262-021-03227-w

Keywords

Search

Navigation