Laparoscopic sleeve gastrectomy in a superobese patient with restenosis of the trachea

Abstract

Introduction Superobese group of patients with body mass index (BMI) ≥ 50 kg/m 2 have higher technical intraoperative problems, higher morbidity, and mortality. Indications for the metabolic procedure are widening and minimally invasive operation dictates that both patients and surgeons face previously assumed "general contraindication" for a surgical bariatric/metabolic procedure. Case outline We present a superobese patient with restenosis of the trachea, chronic obstructive pulmonary disease, sleep apnea, and cardiomyopathy with panniculus grade IV, in whom, as a multidisciplinary team, we simultaneously performed permanent tracheostomy, laparoscopic sleeve gastrectomy, and panniculectomy. Conclusion Quality of life after the bariatric operation must be a leading factor in regard to the approach to a difficult patient, with the operation adaptable enough to fit all demands.