Technical aspects of laparoscopic sleeve gastrectomy in 25 morbidly obese patients

Osnat Givon-Madhala, Rona Spector, Nir Wasserberg, Nahum Beglaibter, Hagit Lustigman, Michael Stein, Nazik Arar, Moshe Rubin

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Laparoscopic sleeve gastrectomy (LSG) has recently come to be performed as a sole bariatric operation. The postoperative morbidity and mortality are cause for concern, and possibly are related to non-standardized surgical technique. Methods: The following is the surgical LSG technique used in 25 morbidly obese patients. Five trocars are used. Division of the vascular supply of the greater gastric curvature is begun at 6-7 cm proximal to the pylorus, proceeding to the angle of His. A 50-Fr calibrating bougie is positioned against the lesser curvature. The LSG is created using a linear staplercutter device with one 4.1-mm green load for the antrum, followed by five to seven sequential 3.5-mm blue loads for the remaining gastric corpus and fundus. The staple-line is inverted by placing a seroserosal continuous absorbable suture over the bougie from the angle of His .The resected stomach is removed through the 12-mm trocar, and a Jackson-Pratt drain is left along the suture-line. Results: The mean operative time was 120 minutes, and length of hospital stay was 4±2 days.There were no conversions to open procedures. There were no postoperative complications (no hemorrhage from the staple-line, no anastomotic leakage, no stricture) and no mortality. In 1 patient, cholecystectomy was also done, and in 4, a gastric band was removed. During a median follow-up of 4 months, BMI decreased from 43±5 kg/m2 to 34±6 kg/m2, and the % excess BMI loss was 49±25%. Conclusions: The proposed surgical technique appears to be a safe and effective procedure for morbid obesity.

Original languageEnglish
Pages (from-to)722-727
Number of pages6
JournalObesity Surgery
Volume17
Issue number6
DOIs
StatePublished - Aug 2007
Externally publishedYes

Keywords

  • Bariatric surgery
  • Laparoscopy
  • Morbid obesity
  • Sleeve gastrectomy
  • Surgical technique

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