Laparoscopic Sleeve Gastrectomy In Morbid Obesity: Early Results Of 240 Patients

Abstract

Background: Laparoscopic sleeve gastrectomy is becoming one of the most common procedures performed for the treatment of morbidly obese patients in the last few years until now.
Objectives: This type of surgery needs to be evaluated regarding the various techniques used and the possible post-operative complications with the exact methods of treating them.
Patients and methods: A retrospective study was conducted on 240 consecutive morbidly obese patients over a period of 3 years (Feb 2011- Mar 2013) in the Saint Raphael Centre of morbid obesity with an average patient body mass index of 45 (35 - 61). They all underwent LSG, and the decreased weight resulting from surgery was analyzed regarding early and late complications. In 40 of the 240 patients, the gastric band was removed 4 weeks prior to the sleeve operation.
Results: Intraoperative difficulties (difficult endotracheal intubation in 7 patients, difficult ports insertion in 6 patients, opening of the staple line in one patient and a bleeding from short gastric vessels in 2 patients). Only 5 patients developed primary haemorrhages (within the first 24 hours post operatively) from the staple line three of them were treated conservatively and the other 2 patients were returned to the theater, no anastomotic leakage or stricture, and no mortality. During a median follow up of 10.6 months (range of 1-3 months), the excess BMI lost reached 52+-23%, and the BMI decreased from 45 +-5 to 33 +- 5 kg/m2. Patient satisfaction scores (1-4) at least one year after surgery was 3.5 +- 0.7.
Conclusion: The early results achieved by following the above outlined surgical steps in 240 consecutive patients who underwent LSG indicates show that this type of morbid obesity surgery is an effective, safe and worthwhile choice for morbidly obese patients as a first treatment option, although long-term results are still pending.