American Society for Metabolic and Bariatric Surgery: care pathway for laparoscopic sleeve gastrectomy

Telem, Dana A.; Gould, Jon C.; Pesta, Carl M.; Powers, Kinga A.; Majid, Saniea F.; Greenberg, Jacob A.; Teixeira, André; Brounts, Lionel R.; Lin, Hsueh-Chun; DeMaria, Eric J.; Rosenthal, Raúl J.

doi:10.1016/j.soard.2017.01.027

Cited by 50 publications

(17 citation statements)

References 130 publications

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“…LSG technique has been previously described in detail [ 7 ]. Venous thromboembolic prophylaxis was initiated within 12 h of surgery and continued for 2 weeks [ 8 ]. A bariatric dietitian provided detailed dietary guidance during recovery [ 9 ].…”

Section: Methodsmentioning

confidence: 99%

Long-term Reported Outcomes Following Primary Laparoscopic Sleeve Gastrectomy

et al. 2022

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Background Long-term laparoscopic sleeve gastrectomy (LSG) outcomes in patients with obesity are scarce. We aimed to examine the outcomes and subjective experience of patients who underwent primary LSG with long-term follow-up. Methods The study is a retrospective observational analysis of patients who underwent primary LSG in a single center with 5–15 years of follow-up. Patients’ hospital chart data supplemented by a detailed follow-up online questionnaire and telephone interview were evaluated. Results The study sample included 578 patients (67.0% female) with 8.8 ± 2.5 years of mean follow-up, with a response rate to the survey of 82.8%. Mean baseline age and body mass index (BMI) were 41.9 ± 10.6 years and 42.5 ± 5.5 kg/m 2 , respectively. BMI at nadir was 27.5 ± 4.9 kg/m 2 , corresponding to a mean excess weight loss (EWL) of 86.9 ± 22.8%. Proportion of patients with weight regain, defined as nadir ≥ 50.0% EWL, but at follow-up < 50.0% EWL, was 34.6% ( n = 200) and the mean weight regain from nadir was 13.3 ± 11.1 kg. BMI and EWL at follow-up were 32.6 ± 6.4 kg/m 2 and 58.9 ± 30.1%, respectively. The main reasons for weight regain given by patients included “not following guidelines,” “lack of exercise,” “subjective impression of being able to ingest larger quantities of food in a meal,” and “not meeting with the dietitian.” Resolution of obesity-related conditions at follow-up was reported for hypertension (51.7%), dyslipidemia (58.1%) and type 2 diabetes (72.2%). The majority of patients (62.3%) reported satisfaction with LSG. Conclusions In the long term, primary LSG was associated with satisfactory weight and health outcomes. However, weight regain was notable. Graphical Abstract

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Section: Methodsmentioning

confidence: 99%

Long-term Reported Outcomes Following Primary Laparoscopic Sleeve Gastrectomy

et al. 2022

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“…The ASMBS guidelines advocates the use of UGIE preoperatively on a selective basis based on the presence of symptoms [16]. This is in contrast to the observation by another study that found significant findings relevant for SG (hiatus hernia, esophagitis, Barrett's esophagus, esophageal dysplasia) in 23% patients, of whom only half were symptomatic and the authors concluded that preoperative UGIE was indicated before SG for all patients irrespective of symptoms [17].…”

Section: Discussionmentioning

confidence: 82%

Perioperative Practices Concerning Sleeve Gastrectomy – a Survey of 863 Surgeons with a Cumulative Experience of 520,230 Procedures

et al. 2019

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Background Sleeve Gastrectomy (SG) is the most commonly performed bariatric procedure worldwide. There is currently no scientific study aimed at understanding variations in practices concerning this procedure. The aim of this study was to study the global variations in perioperative practices concerning SG. Methods A 37-item questionnaire-based survey was conducted to capture the perioperative practices of the global community of bariatric surgeons. Data were analysed using descriptive statistics. Results Response of 863 bariatric surgeons from 67 countries with a cumulative experience of 520,230 SGs were recorded. A total of 689 (80%) and 764 (89%) surgeons listed 13 absolute and relative contraindications, respectively. 65% (n = 559) surgeons perform routine preoperative endoscopy and 97% (n=835) routinely use intraoperative orogastric tube for sizing the resection. A wide variation is observed in the diameter of the tube used. 73% (n=627) surgeons start dividing the stomach at a distance of 3-5 cm from the pylorus, and 54% (n=467) routinely use staple line reinforcement. Majority (65%, n=565) of surgeons perform routine intraoperative leak test at the end of the procedure, while 25% (n=218) surgeons perform a routine contrast study in the early postoperative period. Lifelong 2 multivitamin/mineral, iron, vitamin D, calcium, and vitamin B12 supplementation is advocated by 66%, 29%, 40%, 38% and 44% surgeons, respectively. Conclusion There is a considerable variation in the perioperative practices concerning SG. Data can help in identifying areas for future consensus building and more focussed studies.

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“…Late dilatation of the sleeve, and occurrence of hiatal hernia could also play a role in the worsening of GERD [81]. It is not recommended to empirically start antacid medication for prophylaxis after LSG [82]. However, for patients who develop reflux after LSG, treatment options are proton-pump inhibitors or conversion to RYGB [83].…”

Section: Gerdmentioning

confidence: 99%

“…Other micronutrient deficiencies that can lead to severe complications include thiamine, folate, and fat-soluble vitamins [85]. Daily micronutrient supplements are necessary, including multivitamin concentrate (with iron, copper, and zinc), calcium citrate with vitamin D, vitamin B12, and elemental iron [82]. However, multivitamins or nutritional supplements are typically not initiated in the immediate postoperative period [82].…”

Section: Nutritional Deficienciesmentioning

confidence: 99%

“…Daily micronutrient supplements are necessary, including multivitamin concentrate (with iron, copper, and zinc), calcium citrate with vitamin D, vitamin B12, and elemental iron [82]. However, multivitamins or nutritional supplements are typically not initiated in the immediate postoperative period [82]. It is necessary to clinically monitor the bariatric patient during the first five years.…”

Section: Nutritional Deficienciesmentioning

confidence: 99%

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Laparoscopic Sleeve Gastrectomy: Outcomes, Safety and Complications

Ansari¹

2021

Bariatric Surgery - From the Non-Surgical Approach to the Post-Surgery Individual Care

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Worldwide, the numbers of laparoscopic sleeve gastrectomy (LSG) performed grown exponentially over the last decade, because of its simplicity, safety profile and excellent outcomes in terms of durable weight loss and improvement of obesity-associated comorbidities. This chapter will provide a comprehensive review on the outcomes of LSG as a metabolic surgery. It appraises LSG\'s short, mid and long term weight loss outcomes, and compares these outcomes with those of other types of bariatric surgery. Then, a wider range of LSG outcomes are discussed, including a variety of comorbidities, clinical, biochemical and inflammatory parameters, while appraising the positive metabolic effects of LSG. The chapter also outlines the issues pertaining to LSG among a range of special populations such as adolescents, the elderly, renal transplant patients and others. The chapter concludes with a review of the safety and most common complications that may be encountered in the short term and long term, including surgical and nutritional complications, as well as mortality.

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American Society for Metabolic and Bariatric Surgery: care pathway for laparoscopic sleeve gastrectomy

Cited by 50 publications

References 130 publications

Long-term Reported Outcomes Following Primary Laparoscopic Sleeve Gastrectomy

Long-term Reported Outcomes Following Primary Laparoscopic Sleeve Gastrectomy

Perioperative Practices Concerning Sleeve Gastrectomy – a Survey of 863 Surgeons with a Cumulative Experience of 520,230 Procedures

Laparoscopic Sleeve Gastrectomy: Outcomes, Safety and Complications

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