Neurological Complication After Laparoscopic Sleeve Gastrectomy: Foot Drop

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The relationship between rapid weight loss and peroneal nerve entrapment neuropathy (PNEN) was shown in various series following bariatric surgery. Thus, we aimed to determine the occurrence of PNEN in our patients who underwent laparoscopic sleeve gastrectomy (LSG) and to reveal the factors contributing to this complication.


We evaluated our series of 635 patients in terms of neurological symptoms following laparoscopic sleeve gastrectomy, retrospectively. We recorded the preoperative data, laboratory vitamin and nutrient levels, weight loss, electromyography (EMG) findings, and treatment modalities of these patients.


Seven out of 635 patients developed foot drop as a result of PNEN after bariatric surgery. The mean total weight loss for these patients was 50.6 kg in 6 months, and 63 kg in 12 months. In the laboratory analyses, we did not detect any signs of vitamin deficiency. EMG findings confirmed the diagnosis.


We demonstrate that rapid weight loss is correlated with the risk of foot drop incidence as a result of PNEN.

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  • 07 July 2020

    Editor's Note: The ownership of the data published in this paper is in dispute. Editorial action may be taken as appropriate once an investigation of the concerns is complete and all parties have been given an opportunity to respond in full.


  1. 1.

    Lim R, Beekley A, Johnson DC, et al. Early and late complications of bariatric operation. BMJ Trauma Surgery & Acute Care Open. 2018;3:e000219.

    Article  Google Scholar 

  2. 2.

    Thaisetthawatkul P, Collazo-Clavell ML, Sarr MG, et al. A controlled study of peripheral neuropathy after bariatric surgery. Neurology. 2004;63:1462–70.

    CAS  Article  Google Scholar 

  3. 3.

    Ellias WJ, Pouratian N, Oskouian RJ, et al. Peroneal neuropathy following successful bariatric surgery. Case report and review of the literature. J Neurosurg. 2006;105:631–5.

    Article  Google Scholar 

  4. 4.

    Koffman BM, Greenfield LJ, Ali II, et al. Neurologic complications after surgery for obesity. Muscle Nerve. 2006;33:166–76.

    Article  Google Scholar 

  5. 5.

    Marciniak C. Fibular (peroneal) neuropathy: electrodiagnostic features and clinical correlates. Phys Med Rehabil Clin N Am. 2013;24:121–37.

    Article  Google Scholar 

  6. 6.

    English WJ, DeMaria EJ, Brethauer SA, et al. American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016. Surg Obes Relat Dis. 2018 Mar;14(3):259–63.

    Article  Google Scholar 

  7. 7.

    Parrott J, Frank L, Rabena R, et al. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 update: micronutrients. Surg Obes Relat Dis. 2017;13(5):727–41.

    Article  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Al-Mulhim AS. Laparoscopic sleeve gastrectomy and nutrient deficiencies: a prospective study. Surg Laparosc Endosc Percutan Tech. 2016;26(3):208–11.

    Article  PubMed  Google Scholar 

  9. 9.

    Stewart JD. Foot drop: where, why and what to do? Pract Neurol. 2008;8:158–69.

    Article  Google Scholar 

  10. 10.

    Weyns FJ, Beckers F, Vanormelingen L, et al. Foot drop as a complication of weight loss after bariatric surgery – is it preventable. Obes Surg. 2007;17(9):1209–12.

    Article  Google Scholar 

  11. 11.

    Parikh M, Issa R, McCrillis A, et al. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases. Ann Surg. 2013;257:231–7.

    Article  Google Scholar 

  12. 12.

    Chang SH. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003–2012. JAMA Surg. 2014;149:275–87.

    Article  Google Scholar 

  13. 13.

    Carolus AE, Becker M, Cuny J, et al. The interdisciplinary management of foot drop. Dtsch Arztebl Int. 2019;116(20):347–54.

    Article  PubMed  Google Scholar 

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Correspondence to Fatih Can Karaca.

Ethics declarations

The study was approved by the institutional review board, and the data were collected in accordance with the principles of the Declaration of Helsinki. The patients were informed about the possible complications and technical details of the surgery, and written informed consent was obtained from each patient.

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The authors declare that they have no conflict of interest.

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Şen, O., Karaca, F.C. & Türkçapar, A. Neurological Complication After Laparoscopic Sleeve Gastrectomy: Foot Drop. OBES SURG 30, 957–960 (2020).

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  • Bariatric surgery
  • Weight loss
  • Drop foot
  • Neurological complications