Laparoscopic Sleeve Gastrectomy for Mildly Obese Patients (Body Mass Index of 30 <35 kg/m²): Operative Outcome and Short-Term Results

Abstract

Background. Data concerning laparoscopic sleeve gastrectomy (LSG) in mild obesity are under investigation. Aim/Objective. May 2010 to May 2012, 122 consecutive patients with preoperative body mass index (BMI) of 33 ± 2.5 kg/m2 (range 30–34.9) undergoing LSG were studied. Mean age was 33 ± 10 years (range 15–60), and 105 (86%) were women. Mean preoperative weight was 91 ± 9.7 kg (range 66–121), and preoperative excess weight was 30 ± 6.7 kg (range 19–43). Comorbidities were detected in 44 (36%) patients. Results. Mean operative time was 58 ± 15 min (range 40–95), and postoperative stay was 1.8 ± 0.19 days (range 1.5–3). There were no admissions to intensive care unit and no deaths within 30 days of surgery. The rates of leaks and strictures were 0%, and of hemorrhage 1.6%. At 12 months, BMI decreased to 24.7 ± 2, and the percentage of excess weight loss (% EWL) reached 76.5%. None of the patients had a BMI below 20 kg/m2. Comorbidities resolved in 70.5% or improved in 29.5%. Patient satisfaction scoring (1–5) at least 1 year after was 4.6 ± 0.8 for body image and 4.4 ± 0.6 for food tolerance. Conclusion. LSG for mildly obese patients has proved to be technically relatively easy, safe, and benefic in the short term.

Results of Laparoscopic Sleeve Gastrectomy in 541 Consecutive Patients with Low Baseline Body Mass Index (30–35 kg/m2)

“…We have previously performed a series of LSG in patients with BMI 30-35 kg/m 2 and evaluated short-term risks and benefits. LSG was technically straightforward and resulted in excellent outcomes without substantial surgical risks [10]. The current series confirms our previously published results in the short and long term and outlines the absence of high gastric leak in this population when LSG is performed by experienced surgeons.…”

“…Similarly to other authors, we have previously reported excellent outcomes without any substantial surgical risks in patients with BMI 30-35 kg/m 2 undergoing LSG [10,11]. Although, the major advantage of LSG is technical simplicity, gastric leaks can occur and remain a dreaded and lifethreatening complication [12,13].…”

“…The technique used for LSG is based on a 5-port approach [10]. Using the Ligasure (Covidien, Minneapolis, MN, USA) vessel sealing device, the vessels of the gastric greater curvature were ligated starting at 4 cm proximal to the pylorus and proceeding to the angle of His where all the attachments of the fundus to the left crus were carefully released to avoid any laceration or thermal injury at this level.…”

Outcomes after Sleeve Gastrostomy: Influence of the Calibrating Bougie

“…But LSG is not complication-free at all and one of the major postoperative complication is still the staple line leak, which occurs in approximately 2.2-2.4% of patients [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. There are various factors which influence the risk of leak.…”

“…Nowadays it has been accepted as a definitive stand-alone procedure due to the excellent results in terms of excess weight loss (%EWL) and control of comorbidities, with significant 3 and 5-year experiences that justify this recommendation [5][6][7][8][9][10][11][12][13][14].…”