Abstract
Background
In the past few years, laparoscopic sleeve gastrectomy (LSG) became a widely used bariatric method. Based on results of recent LSG studies, LSG is being increasingly used even as a single bariatric method. On contrary with some other reports, we do not reinforce the LSG staple line with over-sewing. Our pilot study presents treatment outcomes and results 18 months after LSG.
Methods
Sixty-one consecutive morbidly obese (MO) patients (19 male and 42 female) who underwent LSG from January 2006 to May 2008 were included into the study. The mean age, height, and weight were 37.3 years (29–57), 168 cm (151–187), and 118 kg (97–181), respectively, while mean body mass index (BMI) was 41.8 (36.1–60.4). LSG started at 6 cm from pylorus and ended at the angle of Hiss. For gastric sleeve calibration 38F, intragastric tube was used. All 61 LSG were performed without over-sewing of the staple line. In the last 24 cases, the staple line was covered with Surgicel™ strips, which were however placed without any fixation to the underlying gastric tissue.
Results
Mean operating time was 105 min (80–170) and no conversion to open surgery. An 18-month follow-up was recorded in 39 MO patients. The mean weight loss was 31.3 (range, 21–67 kg) and mean % excess BMI loss reached 72% (range, 64–97%). Neither leak nor disruptions of the staple line and/or sleeve dilatation were recorded.
Conclusion
LSG is an effective and safe bariatric procedure with low incidence of complications and mortality in our experience.
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References
Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg 2007;17:1297–305.
Chu CA, Gagner M, Quin T, et al. Two-stage laparoscopic biliopancreatic diversion with duodenal switch: an alternative approach to super-super morbid obesity. Surg Endosc 2003;16:S069. (Abstract).
Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg 2007;17:962–9.
Selecchia G, Boru C, Pecchia A, et al. Effectivness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbities in super-obese high-risk patients. Obes Surg 2006;16:1138–44.
Baltasar A, Serra C, Perez N, et al. Laparoscopic sleeve gastrectomy: multi-purpose bariatric operation. Obes Surg 2005;15:1124–8.
Mognol P, Chosidow D, Marmuse JP. Laparoscopic sleeve gastrectomy as an initial bariatric for hi-risk patients: initial result in 10 patients. Obes Surg 2005;15:1030–3.
Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg 2005;15:1024–9.
Moon Han S, Kim WW, Oh JH. Result of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly Korean patients. Obes Surg 2005;15:1469–75.
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;17:1069–74.
Himpens J, Dapri G, Cadière GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: result after 1 and 3 years. Obes Surg 2006;16:1450–6.
Kasalicky M, Michalsky D, Housova J, et al. Laparoscopic gastric tubulisation - sleeve gastrectomy—another option for bariatric food intake restriction in morbidly obese subjects. Rozhl Chir 2007;86:601–6.
Fried M, Hainer V, Basdevand A, et al. Interdisciplinary European guidelines for surgery of severe (morbid) obesity. Obes Surg 2007;17:260–70.
Bernante P, Foletto M, Busetto L, et al. Feasibility of laparoscopic sleeve gastrectomy as a revisional procedure for prior laparoscopic gastric banding. Obes Surg 2006;16:1327–30.
Gagner M, Inabnet WB, Pomp A. Laparoscopic sleeve gastrectomy with second stage biliopancreatic diversion and duodenal switch in the superobese. In: Inabnet WB, DeMaria EJ, Ikramuddin S, editors. Laparoscopic bariatric surgery. Philadelphia: Lippincott William & Wilkins; 2005. pp. 143–50.
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;16:1323–6.
Pereferrer FS, González MH, Rovira FA, et al. Influence of sleeve gastrectomy on several experimental models of obesity: Metabolic and hormonal implications. Obes Surg 2008;18:97–108.
Kotidis EV, Koliakos G, Papavramidis TS, et al. The effect of biliopancreatic diversion with pylorus-preserving sleeve gastrectomy and duodenal switch on fasting serum ghrelin, leptin and adiponectin levels: is there a hormonal contribution to the weight-reducing effect of this procedure? Obes Surg 2006;16:554–9.
Braghetto I, Korn O, Valladares H, et al. Laparoscopic sleeve gastrectomy: Surgical technique, indications and clinical results. Obes Surg 2007;17:1442–50.
Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy—a restrictive procedure? Obes Surg 2007;17:57–62.
Cottam D, Qureshi FG, Mattar DG, et al. Laparoscopic sleeve gastretomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc 2006;20:859–63.
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Kasalicky, M., Michalsky, D., Housova, J. et al. Laparoscopic Sleeve Gastrectomy without an Over-Sewing of the Staple Line. OBES SURG 18, 1257–1262 (2008). https://doi.org/10.1007/s11695-008-9635-3
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DOI: https://doi.org/10.1007/s11695-008-9635-3