Obesity Surgery

, Volume 20, Issue 3, pp 276–282 | Cite as

Laparoscopic Sleeve Gastrectomy Performed with Intent to Treat Morbid Obesity: A Prospective Single-Center Study of 261 Patients with a Median Follow-up of 1 Year

  • Evangelos Menenakos
  • Konstantinos M. Stamou
  • Konstantinos Albanopoulos
  • Joanna Papailiou
  • Demetrios Theodorou
  • Emmanuel Leandros
Clinical Report



The aim of the study is to look at laparoscopic sleeve gastrectomy as a procedure with intent to cure morbid obesity. Secondary endpoints are related to the safety profile of the procedure.


This is a prospective clinical study conducted in a single university surgical clinic.


Two hundred sixty-one patients (2.5:1 female to male ratio, median age of 37 years) underwent sleeve gastrectomy. Median preoperative body mass index (BMI) was 45.2 kg/m2. Mortality and morbidity rates were 0.7% and 8.4%, respectively. Risk factors for postoperative complications were history of diabetes mellitus under medical treatment (OR, 4.0; p = 0.014) and prior bariatric operation on the same patient (OR, 5.7, p = 0.034). Median follow-up was 12 months (range 1–29 months). A BMI > 50 kg/m2 is connected with greater weight loss. Analysis of the percentage of excess weight loss (%EWL) during follow-up at specific time intervals showed a rapid increase for the first 12 months followed by a more gradual rise thereafter. The median %EWL for the first year of follow-up was 65.7 (range 33.8–102.3). The median BMI for the patients that had completed at least 1 year of follow-up was 30.5 kg/m2 (range 21.2–42.7). The overall success rate after the first year was 74.3% when accounted for %EWL > 50 and 81.7% for BMI < 35 kg/m2.


The actual long-term efficacy of the procedure remains to be confirmed. Morbidity rates may prove higher than expected especially during the learning curve.


Laparoscopic sleeve gastrectomy Morbid obesity 


  1. 1.
    World Health Organization. World Health Report 2002. Available at:
  2. 2.
    WHO Global InfoBase online [online database]. Geneva, World Health Organization, 2007 (noncommunicable diseases, comparable estimates).
  3. 3.
    Parikh M, Gagner M, Heacock L, et al. Laparoscopic sleeve gastrectomy: does bougie size affect mean %EWL? Short-term outcomes. Surg Obes Relat Dis. 2008;4(4):528–3.CrossRefPubMedGoogle Scholar
  4. 4.
    Rosenthal R. Laparoscopic sleeve gastrectomy: does bougie size affect mean percentage of excess weight loss? Short-term outcomes. Surg Obes Relat Dis. 2008;4(5):687–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Lee CM, Cirangle PT, Jossart GH. Vertical gastrectomy for morbid obesity in 216 patients: report of two-year results. Surg Endosc. 2007;21(10):1810–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Hamoui N, Anthone GJ, Kaufman HS, et al. Sleeve gastrectomy in the high-risk patient. Obes Surg. 2006;16(11):1445–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Eisendrath P, Cremer M, Himpens J, et al. Endotherapy including temporary stenting of fistulas of the upper gastrointestinal tract after laparoscopic bariatric surgery. Endoscopy. 2007;39(7):625–30.CrossRefPubMedGoogle Scholar
  8. 8.
    Bernante P, Foletto M, Busetto L, et al. Feasibility of laparoscopic sleeve gastrectomy as a revision procedure for prior laparoscopic gastric banding. Obes Surg. 2006;16(10):1327–30.CrossRefPubMedGoogle Scholar
  9. 9.
    Nocca D, Krawczykowsky D, Bomans B, et al. A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obes Surg. 2008;18(5):560–5.CrossRefPubMedGoogle Scholar
  10. 10.
    Givon-Madhala O, Spector R, Wasserberg N, et al. Technical aspects of laparoscopic sleeve gastrectomy in 25 morbidly obese patients. Obes Surg. 2007;17(6):722–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy: a restrictive procedure? Obes Surg. 2007;17(1):57–62.CrossRefPubMedGoogle Scholar
  12. 12.
    Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg. Endosc. 2006;20(6):859–63.CrossRefPubMedGoogle Scholar
  13. 13.
    Roa PE, Kaidar-Person O, Pinto D, et al. Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obes Surg. 2006;16(10):1323–6.CrossRefPubMedGoogle Scholar
  14. 14.
    Himpens J, Dapri G, Cadière GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16(11):1450–6.CrossRefPubMedGoogle Scholar
  15. 15.
    Silecchia G, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg. 2006;16(9):1138–44.CrossRefPubMedGoogle Scholar
  16. 16.
    Vidal J, Ibarzabal A, Nicolau J, et al. Short-term effects of sleeve gastrectomy on type 2 diabetes mellitus in severely obese subjects. Obes Surg. 2007;17(8):1069–74.CrossRefPubMedGoogle Scholar
  17. 17.
    Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17(7):962–9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Evangelos Menenakos
    • 1
    • 2
  • Konstantinos M. Stamou
    • 1
    • 2
  • Konstantinos Albanopoulos
    • 1
    • 2
  • Joanna Papailiou
    • 1
    • 2
  • Demetrios Theodorou
    • 1
    • 2
  • Emmanuel Leandros
    • 1
    • 2
  1. 1.Department of Endoscopic SurgeryHippocratio HospitalAthensGreece
  2. 2.1st Department of Propaedeutic SurgeryHippocratio HospitalAthensGreece

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