Obesity Surgery

, 17:1297 | Cite as

Laparoscopic Sleeve Gastrectomy — Influence of Sleeve Size and Resected Gastric Volume

  • Rudolf A. WeinerEmail author
  • Sylvia Weiner
  • Ingmar Pomhoff
  • Christoph Jacobi
  • Wojciech Makarewicz
  • Gerhard Weigand


Although the efficacy of laparoscopic sleeve gastrectomy (LSG) for morbidly obese patients with a BMI of <50 kg/m2, the incidence of weight gain by change of eating behaviors, and gastric dilatation following LSG have not been investigated thus far, LSG is becoming more common as a single-stage operation for the treatment morbid obesity.


This is a prospective study of the initial 120 patients who underwent isolated LSG. Initially, the LSG was performed without a calibration tube and resulted in high sleeve volumes (group 1: n=25). In group 2 (n=32), a calibration tube of 44 Fr and in group 3 (n=63) a calibration tube of 32 Fr were used. The study group consists of 101 patients with high BMI who were scheduled for a two-step LBPD-DS, but rejected the second step after 1 year. Study endpoints include estimated sleeve volume, volume of removed stomach, operative time, complication rates, length of hospital stay, changes in co-morbidity, percentage of excess BMI loss (%EBL) and changes in BMI (kg/m2).


All 3 groups were comparable regarding age, gender, and co-morbidities. There was no hospital mortality, but there was one case of late mortality (0.8%). 2 early leaks (1.7%) were seen. % excess BMI loss was significantly higher for patients who underwent LSG with tube calibrations. LSG with large sleeve volume showed a slight weight gain during 5 years of observation. A total of 16 patients (13.3%) underwent a second stage procedure within a period of 5 years (2 redo-sleeves, 7 LBPD-DS, 3 LRYGBP).


Early weight loss results were not different between the groups, but after 2 years the more restrictive LSG (groups 2, 3) results were significantly better than in patients without calibration. A removed gastric volume of <500 cc seems to be a predictor of failure in treatment or early weight regain. A statistically significant improved health status and quality of life were registered for all groups. The general introduction of LSG as a one-stage restrictive procedure in the bariatric field can be considered only if the procedure is standardized and long-term results are available.

Key words

Morbid obesity bariatric surgery laparoscopic sleeve gastrectomy sleeve volume volume of removed stomach weight loss 


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Copyright information

© Springer Science + Business Media B.V. 2007

Authors and Affiliations

  • Rudolf A. Weiner
    • 1
    • 4
    Email author
  • Sylvia Weiner
    • 1
  • Ingmar Pomhoff
    • 1
  • Christoph Jacobi
    • 2
  • Wojciech Makarewicz
    • 3
  • Gerhard Weigand
    • 1
  1. 1.Center for Minimal-Invasive Surgery, Department of General and Bariatric SurgeryKrankenhaus SachsenhausenFrankfurt/M.Germany
  2. 2.Department of Surgery (Charite`)Humboldt-UniversityBerlinGermany
  3. 3.Department of General, Endocrine and Transplant SurgeryMedical University of GdanskGdanskPoland
  4. 4.Department of SurgeryKrankenhaus SachsenhausenFrankfurt am MainGermany

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