Laparoscopic sleeve gastrectomy as a single-stage bariatric procedure

Abstract

Background: Laparoscopic sleeve gastrectomy is increasingly being used as a stand-alone procedure in bariatric surgery, with medium-term follow-up data now emerging. We present our early experience in patients with a mean body mass index (BMI) in the super-obese range.

Methods: Review of prospectively collected data for the first 100 patients who underwent laparoscopic sleeve gastrectomy at Counties Manukau District Health Board between March 2007 and July 2008.

Results: One hundred patients were identified, with a mean age of 43 years (range, 20-60 years). Maori and Pacific Islanders made up 31% of the patient subset. Patients had a mean BMI of 50.3 kg/m(2) (range, 34.5-72.8 kg/m(2)). Forty-five patients were super-obese. The median hospital stay was 2 days (range, 1-7 days). Mean follow-up was 12.0 months (range, 0.9-23.3 months). Mean excess weight loss was 62.9% (range, 7.2-129.0%). Twenty-five percent of patients were diabetic and 45% of patients were hypertensive pre-operatively. Diabetics and hypertension resolved or improved in 72% and 60% of patients, respectively. There was a major complication rate of 7%, including three staple-line leaks (one requiring laparotomy), two staple-line bleeds (one requiring laparotomy) and one infected haematoma. There were no deaths.

Conclusions: In this public hospital setting, laparoscopic sleeve gastrectomy has achieved satisfactory weight loss results with an acceptable complication rate in the medium-term.