Laparoscopic Sleeve Gastrectomy, 200 Cases without a Leak: Short-Term Results, complications and Technical Considerations.

Asem Ghasoup, MD, FACS1, Turki Al Qurashi, MD1, Mohammed Widinly, MD1, Omar Sadieh, MD, FACS2. 1Security Forces Hospital Makkah, 2Saad specialty Hospital

Background: Morbid obesity has become a major health problem in Saudi Arabia. Laparoscopic sleeve gastrectomy is an accepted method among bariatric surgeons for treating morbidly obese patients with a reduced rate of complications. We describe results of a single surgeon’s experience in our institution with LSG revealing a low complication rate and describing the surgical technique.

Methods: LSG was performed in 200 consecutive patients from June 2014 to June 2015.

A technique is described where all operations were performed with avoiding strictures at the incisura angularis and stapling close to the esophagus at the angle of His.

All operations performed used over sewing of the staple line.

Results: Follow-up data was collected for all patients at 12 weeks. A total complication rate of 4.1% and a 1.3% 30-day readmission rate were observed. No leaks occurred in any of the 200 patients. The most common complications were nausea and vomiting with dehydration. The percentages of excess weight loss were 38.3, 57.8 and 64.4 with a follow-up of 68%, 61%, and 47% at 6 months.

Conclusion: LSG can be performed for treatment of morbid obesity with a low complication rate. Surgeons performing LSG should minimize the risk of creating strictures at the incisura angularis and stapling near the esophagus at the angle of His.

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