Laparoscopic Sleeve Gastrectomy for Morbid Obesity with Intra-operative Endoscopic Guidance. Immediate Peri-operative and 1-year Results after 25 Patients

Laparoscopic sleeve gastrectomy (LSG) represents a promising alternative option for the surgical treatment of morbid obesity. Its standard technique includes the longitudinal division of the stomach along a bougie of varying diameter. We report in this retrospective study our experience with LSG being performed with the use of intra-operative endoscopy instead of the bougie. Twenty-five consecutive patients (18 women, seven men) with a mean age of 40.2 years and mean body weight of 152.1 kg were submitted to LSG with intra-operative endoscopy in our hospital. The mean preoperative BMI was 53.5 kg/m². There were no conversions. Mean operative time was 117.5 min. There was no morbidity or mortality. The mean loss of excess body weight (EBW) at 3 months post-op was 19 ± 1.8 kg, at 6 months was 28.6 ± 4.5 kg, and at 1 year post-op was 48.9 ± 3.7 kg (min 11–max 92). In other words the patients had lost 30 ± 5%, 45 ± 7.7%, and 60.8 ± 4.3% of their EBW, respectively. The mean excess body weight loss at the day of the last visit to our outpatient clinic was 52.3 ± 4.3 kg which corresponded to 66.4 ± 4.3% of the total excess weight. LSG with intra-operative endoscopic guidance is a safe and efficient alternative method to treat morbid obesity and is a viable option for surgical units familiar with endoscopic techniques.