Laparoscopic Sleeve Gastrectomy: A Multi-purpose Bariatric Operation

Abstract

LSG may become the ideal operation for staging in patients with BMI >55, for treating morbidly obese patients with severe medical conditions, as an excellent alternative to adjustable bands in lower BMI patients, or for conversion of gastric banding patients.

Laparoscopic sleeve gastrectomy: perioperative outcomes, weight loss and impact on type 2 diabetes mellitus over 2 years

“…1 Several groups, however, reported adequate, sustained weight loss following the sleeve. 2,3 The ability to perform this procedure laparoscopically contributed to the enthusiasm for the sleeve gastrectomy as a final procedure for the treatment of morbid obesity. 4 Being a fairly novel procedure, laparoscopic sleeve gastrectomy (LSG) lacks long-term data, but short-term and intermediate results confirm its effectiveness at inducing and maintaining weight loss and addressing obesityrelated comorbidities.…”

Updated Review of Sleeve Gastrectomy

“…LSG has demonstrated weight-loss results comparable to LRYGB and LBPD-DS but with a lower morbidity profile, associated with improvement of health status and resolution of co-morbidities such as diabetes, hypertension, OSA and dyslipidemia [16,18,38,41,44,45,47,48]. Silecchia et al [44] showed that in 41 super-obese patients (9 patients with BMI > 60 kg/m ) following LSG, 60% of major comorbidities were resolved and 24% improved, 57.8% of patients were co-morbidity-free and 31.5% had only one major co-morbidity.…”

“…SG was initially conceived as a "purely" restrictive procedure [15,18] even though it allows a normal eating behaviour that is considered a major advantage for the SG over standard restrictive procedures.…”

“…We still do not know how much antrum we should preserve in order to obtain better results in terms of weight loss. In Spain, Baltasar et al [18] advocate resection of the antrum by completing the greater curvature dissection distal to the pylorus so that the firing can start 2 cm proximal to the pylorus with the linear stapler positioned toward the incisura angularis and close to a 32-Fr bougie that follows the lesser curvature, or firing 3-4 cm proximal to the pylorus in BPD-DS.…”

“…worldwide [16][17][18] due to its major potential benefits, including its technical simplicity and significant weight-loss outcomes with low rate of complications and mortality.…”