scholarly journals Safety and effectiveness of reduced-port laparoscopic sleeve gastrectomy in Asian morbidly obese patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yeshong Park ◽  
Young Suk Park ◽  
Sangjun Lee ◽  
So Hyun Kang ◽  
Eunju Lee ◽  
...  

AbstractLaparoscopic sleeve gastrectomy is the most frequently performed surgical intervention in patients with morbid obesity. Single-port sleeve gastrectomy (SPSG) and reduced-port sleeve gastrectomy (RPSG) are increasingly reported in the literature. This study compared the short-term outcomes of SPSG, RPSG, and conventional laparoscopic sleeve gastrectomy (CLSG). This is a single-center retrospective study of 238 morbidly obese patients, of whom 148 (62.2%) patients completed follow-up one year after surgery. Propensity score matching was performed on factors influencing the choice of approach, and fifty patients from the SPSG + RPSG and CLSG groups were successfully matched. The groups were comparable in postoperative weight loss, morbidity, pain, and resolution of obesity-related comorbidities. The percentage of excess weight loss after one year was 90.0% in the SPSG + RPSG group and 75.2% in the CLSG group (P < 0.001). Complication rates showed no significant difference. The CLSG group was superior in dyslipidemia remission (17 [37.0%] vs. 28 [63.6%], P = 0.018) in the total cohort; however, this difference disappeared after matching. Our results suggest that single-port and reduced-port approaches could be alternative choices for selected patients. As our study was limited by its retrospective nature and potential selection bias, further studies are necessary to set standardized guidelines for SPSG.

2021 ◽  
Author(s):  
Mohsen Tabasi ◽  
Marziye Farsimadan ◽  
Hamidreza Iranpour ◽  
Fezzeh Elyasinia ◽  
Mohammad Reza Yazdannasab ◽  
...  

Abstract The outcome of laparoscopic sleeve gastrectomy (LSG), one of the most common bariatric surgery (BS) procedure, may differ depending on the patient’s age, gender, preoperative BMI. In this study, we aimed to evaluate the efficacy of LSG technique on weight loss, obesity-associated co-morbidities and complications in patients undergoing LSG over three months and one year, regarding their age, gender, and BMI. The LSG associated complications in participants regarding their preoperative BMI (<39.9 and >39.9), age (30-40 and 40-50), and gender were assessed after 2 3 and 12 months. Besides, the remission and improvement rates of comorbid conditions in patients were examined after 12 months of LSG. Our results showed that LSG led to a significant weight loss in the resolution of obesity-associated co-morbidities and different complications after one year. No significant difference was found in the improvement and the resolution of obesity-associated co-morbidities according to gender. Also, the class 3 patients had significantly higher rates of hearing loss after 12 months and had higher levels of depression and brittle nails three months after the surgery. The younger patients also showed a significantly higher percentage of dry skin, intolerance to bread, and menstrual disorder compared to the older group.


2020 ◽  
Vol 27 (3) ◽  
pp. 265-271
Author(s):  
Nesreen Khidir ◽  
Michel Gagner ◽  
Moamena El Matbouly ◽  
Walid El Ansari ◽  
Helmuth Billy ◽  
...  

Background. The Single-Port Instrument Delivery Extended Reach (SPIDER) surgical system is a safe revolutionary technology that defeated difficulties of single-incision surgery. We assessed the long-term outcomes of SPIDER sleeve gastrectomy (SPIDER SG) versus conventional laparoscopic sleeve gastrectomy (LSG) in morbidly obese patients. Methods. Retrospective review of patients who underwent SPIDER SG or LSG in our center matched by the date of surgery (2012-2013). We reviewed weight loss results up to 5 years, complication rates, procedure and hospitalization durations, financial cost, and effect on comorbidities. Results. Patients underwent 200 SPIDER SG and 220 LSG. At baseline, SPIDER SG versus LSG patients had a mean body mass index of 43.8 ± 5.6 and 48.6 ± 8.1 kg/m2, respectively. At 1 year, both groups had comparable percentage of excess weight loss (%EWL). At 5 years, SPIDER SG had %EWL of 54.6 ± 24.8 compared with 57.8 ± 29.9 in LSG ( P = .4). Nine SPIDER SG (4.5%) required conversion to LSG. Complications occurred in both groups: 4% versus 4.1% ( P = .95). At 2-year follow-up, diabetes mellitus was reversed in 43% of SPIDER SG and 62% LSG. Despite a shorter hospital stay in SPIDER SG, the total cost was significantly higher ($2 041 477) compared with LSG ($1 773 834). The mean score of scar satisfaction was significantly more in SPIDER SG. Conclusions. SPIDER SG was safe with long-term effects on weight loss comparable to LSG. Despite the higher cost of SPIDER SG, a shorter hospital stay and better cosmesis were observed.


2011 ◽  
Vol 22 (4) ◽  
pp. 555-559 ◽  
Author(s):  
Jesus E. Hidalgo ◽  
Mayank Roy ◽  
Alexander Ramirez ◽  
Samuel Szomstein ◽  
Raul J. Rosenthal

2021 ◽  
Vol 15 (7) ◽  
pp. 2269-2271
Author(s):  
Rahmat Ullah Shah ◽  
Adnan Badar ◽  
Hafiz Niamat Ullah ◽  
Sadia Shah ◽  
Sheikh Muhammad Ibqar Azeem ◽  
...  

Objective: To determine the early outcomes of laparoscopic sleeve gastrectomy with respect to weight loss and amelioration of comorbid conditions in morbidly obese patients. Study Design: Prospective descriptive study. Place and Duration of Study: MTI-Lady Reading hospital Peshawar and Royal Imperial hospital Swat from January 2018 to January 2020. Materials and Methods: Total thirty-eight morbidly obese patients of either sex with age range of 25-65 years were included in this study. Informed written consent was taken from all the patients and their demographic details such as age, sex and comorbid conditions were recorded. All the patients underwent laparoscopic sleeve gastrectomy. Preoperative and postoperative data such as body mass index, total & excess weight loss and impact on comorbidities were analyzed. Bariatric Analysis and Reporting Outcome System (BAROS) scoring system was used to analyze the outcomes. Follow-up was taken at 1 year post-operatively. Results: Majority were female 25 (65.8%) patients and 13 (34.2%) males with mean age of 45.39±9.64 years. Comorbidities such as hypertension, diabetes mellitus, hyperlipidemia and obstructive sleep apnoea were recorded in 13.2%, 26.3%, 7.9% and 10.53% patients respectively. Mean excess body weight loss (EWL) was 60.25±12.7 kg and mean body mass index loss was 15.14+9.33 kg/m2at 1 year follow up. Postoperative systolic blood pressure improvement was observed in 23 (60.5%) patients. A significant improvement was observed regarding diabetes mellitus (preoperatively mean HbA1C 9.7±5.9 vs postoperatively mean HbA1C 4.42±3.6) p-value <0.001. According to the BAROS score, 5 (13.3%) showed excellent, 14 (36.8%) showed very good, 17 (44.74%) showed good, 2 (5.3%) showed fair and no patient showed poor outcomes. Satisfaction rate among patients was 94.7%. Conclusion: Laparoscopic sleeve gastrectomy is an excellent procedure both in terms of weight loss and amelioration of comorbid conditions in morbidly obese patients. Key words: Sleeve gastrectomy, Laparoscopic, Excess body weight loss, Morbid obesity


2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Andrea Figura ◽  
Anne Ahnis ◽  
Andreas Stengel ◽  
Tobias Hofmann ◽  
Ulf Elbelt ◽  
...  

Background. The amount of excess weight loss (%EWL) among obese patients after bariatric surgery varies greatly. However, reliable predictors have not been established yet. The present study evaluated the preoperative psychological burden, coping style, and motivation to lose weight as factors determining postoperative treatment success.Methods. The sample included 64 morbidly obese patients with a preoperative BMI of51±8 kg/m2who had undergone laparoscopic sleeve gastrectomy (LSG). Well-established questionnaires were applied before surgery to assess the psychological burden in terms of “perceived stress” (PSQ-20), “depression” (PHQ-9), “anxiety” (GAD-7), and “mental impairment” (ISR) as well as coping style (Brief COPE) and motivation to lose weight. %EWL as an indicator for treatment success was assessed on average 20 months after surgery.Results. Based on the %EWL distribution, patients were classified into three %EWL groups: low (14–39%), moderate (40–59%), and high (60–115%). LSG patients with high %EWL reported significantly more “active coping” behavior prior to surgery than patients with moderate and low %EWL. Patients’ preoperative psychological burden and motivation to lose weight were not associated with %EWL.Conclusion. An “active coping” style might be of predictive value for better weight loss outcomes in patients following LSG intervention.


2021 ◽  
Author(s):  
zhiyong dong ◽  
Christine Stier ◽  
Wenhui Chen ◽  
Tsz Hong Chong ◽  
Jingge Yang ◽  
...  

Abstract Background Laparoscopic sleeve gastrectomy (LSG) is considered a standard bariatric procedure, which is easy to perform. However, there are pitfalls to be aware of, because complications from the operation, on the other hand, pose great challenges. Methods We describe our innovative three-port-technique of LSG in a step-by-step instruction. To investigate the safety and efficacy, a retrospective evaluation and analysis was performed on consecutive 116 patients. For this purpose, the operation time, complication rates and weight loss were recorded.Results Mean BMI was 35.47 ± 4.53 kg Mean procedure duration was 90.13 ± 5.68 mins. Mean weight loss achieved was 11.57 ± 5.09 kg at first month; 19.75 ± 6.57 kg at third month; 26.85 ± 7.60 kg at sixth month, and 28.86 ± 11.23 kg at one year. According to the Clavien-Dindo classification, no seriously complications were observed after 1, 3, 6 12 months follow-up. Conclusion LSG in this innovative three-port technique can be performed safely with a convincing outcome.


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