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Published in: Obesity Surgery 10/2008

01-10-2008 | Research Article

Laparoscopic Sleeve Gastrectomy without an Over-Sewing of the Staple Line

Authors: Mojmir Kasalicky, David Michalsky, Jitka Housova, Martin Haluzik, Daniel Housa, Denisa Haluzikova, Martin Fried

Published in: Obesity Surgery | Issue 10/2008

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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.
Literature
1.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
2.
go back to reference 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). 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).
3.
go back to reference Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg 2007;17:962–9.PubMedCrossRef Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg 2007;17:962–9.PubMedCrossRef
4.
go back to reference 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.CrossRef 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.CrossRef
5.
go back to reference Baltasar A, Serra C, Perez N, et al. Laparoscopic sleeve gastrectomy: multi-purpose bariatric operation. Obes Surg 2005;15:1124–8.PubMedCrossRef Baltasar A, Serra C, Perez N, et al. Laparoscopic sleeve gastrectomy: multi-purpose bariatric operation. Obes Surg 2005;15:1124–8.PubMedCrossRef
6.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
7.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
8.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
9.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
10.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
11.
go back to reference 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.PubMed 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.PubMed
12.
go back to reference Fried M, Hainer V, Basdevand A, et al. Interdisciplinary European guidelines for surgery of severe (morbid) obesity. Obes Surg 2007;17:260–70.PubMedCrossRef Fried M, Hainer V, Basdevand A, et al. Interdisciplinary European guidelines for surgery of severe (morbid) obesity. Obes Surg 2007;17:260–70.PubMedCrossRef
13.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
14.
go back to reference 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. 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.
15.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
16.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
17.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
18.
go back to reference Braghetto I, Korn O, Valladares H, et al. Laparoscopic sleeve gastrectomy: Surgical technique, indications and clinical results. Obes Surg 2007;17:1442–50.PubMedCrossRef Braghetto I, Korn O, Valladares H, et al. Laparoscopic sleeve gastrectomy: Surgical technique, indications and clinical results. Obes Surg 2007;17:1442–50.PubMedCrossRef
19.
go back to reference Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy—a restrictive procedure? Obes Surg 2007;17:57–62.PubMedCrossRef Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy—a restrictive procedure? Obes Surg 2007;17:57–62.PubMedCrossRef
20.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
Metadata
Title
Laparoscopic Sleeve Gastrectomy without an Over-Sewing of the Staple Line
Authors
Mojmir Kasalicky
David Michalsky
Jitka Housova
Martin Haluzik
Daniel Housa
Denisa Haluzikova
Martin Fried
Publication date
01-10-2008
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 10/2008
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-008-9635-3

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