Laparoscopic Sleeve Gastrectomy for the Surgical Treatment of Obesity: Is It an Easy Procedure?

Laparoscopic sleeve gastrectomy (LSG) is currently the most performed bariatric procedure in the world. The 4th International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Global registry report (2014-18) estimates 87,015 procedures, equal to 45.9% of all bariatric procedures. Initially performed as the first step of the duodenals witch (biliopancreatic diversion with duodenal switch (BPD-DS)), a very complex malabsorptive procedure invented by a Canadian Surgeon P. Marceau as an evolution of the BPD, invented by N. Scopinaro, an Italian surgeon, LSG established itself in the early 2000s as a stand alone procedure, especially following the observations of Michael Gagner, pioneer of bariatric surgery. Over the years LSG has grown rapidly. The reasons for this popularity are the relative technical simplicity compared to other procedures, efficacy, good quality. For these reasons there has been a real explosion of bariatric surgery: many surgeons, driven by the relative simplicity of the procedure (longitudinal gastrectomy on the guide of a probe), begun to propose this procedure. So is LSG really an effective simple procedure that is good for all patients? Absolutely not. Performing a longitudinal gastrectomy can be simple; performing a good LSG is not.

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Comprehensive Care for Bariatric Surgery Patients

AACN Advanced Critical Care ◽

10.4037/aacnacc2017410 ◽

2017 ◽

Vol 28 (3) ◽

pp. 263-274

Author(s):

Aura Petcu

Keyword(s):

Bariatric Surgery ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Treatment Options ◽

Surgical Care ◽

The United States ◽

Bariatric Patients ◽

Technical Simplicity ◽

Perioperative Course

Obesity is a worldwide epidemic, and those suffering from obesity have increased morbidity and mortality rates. There are various causes of obesity and many treatment options for patients suffering from obesity, including nonsurgical treatments. However, bariatric surgery is often the best choice for optimal weight loss and the attenuation of comorbidities. Currently, laparoscopic sleeve gastrectomy is the most common type of bariatric surgery in the United States due to its technical simplicity, feasibility, and overall positive outcomes. This article discusses bariatric surgical criteria and selection, expected perioperative course, potential complications after surgery, and nursing implications for the care of bariatric patients. A case report is used to exemplify stages of surgical care and follow-up treatment for patients who undergo laparoscopic sleeve gastrectomy.

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Efficacy of laparoscopic sleeve gastrectomy for patient with morbid obesity and type 1 diabetes mellitus: a case report

Surgical Case Reports ◽

10.1186/s40792-020-00989-5 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Hidetaka Ichikawa ◽

Hirofumi Imoto ◽

Naoki Tanaka ◽

Hiroaki Musha ◽

Shojiro Sawada ◽

...

Keyword(s):

Diabetes Mellitus ◽

Bariatric Surgery ◽

Morbid Obesity ◽

Body Weight ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Hba1c Level ◽

Insulin Dose ◽

Body Weight Loss

Abstract Background Bariatric surgery is effective for the treatment of patients with morbid obesity and type 2 diabetes mellitus (T2DM), for body weight loss and glycemic control. However, in Japan, there has been no previous report of the effectiveness bariatric surgery in a case of morbid obesity associated with acute onset type 1 diabetes mellitus (T1DM), in which pancreatic β-cells were destroyed and endogenous insulin was depleted. Case presentation A 36-year-old woman with morbid obesity and T1DM, diagnosed when she was 6 years, was admitted for bariatric surgery. At her first consultation, she had a body weight of 106.7 kg and a body mass index of 42.2 kg/m2. Her HbA1c level was 9.0%, with a required daily insulin dose of 75 units. She underwent laparoscopic sleeve gastrectomy. At 1 year after surgery, her body weight had decreased to 81.0 kg and her body mass index to 32.2 kg/m2. In addition, her daily required dose of insulin had decreased to 24 units, with an improvement in her HbA1c level to 7.7%. Conclusions Although further evidence needs to be accumulated, including long-term outcomes, laparoscopic sleeve gastrectomy may provide an effective treatment for patients with morbid obesity and T1DM for body weight loss, improvement in HbA1c level, and insulin dose reduction.

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LAPAROSCOPIC SLEEVE GASTRECTOMY IN THE TREATMENT OF OBESITY – CASE REPORT

Jurnalul de Chirurgie ◽

10.7438/1584-9341-9-1-9 ◽

2013 ◽

Vol 9 (1) ◽

pp. 71-76

Author(s):

L. Alecu ◽

A. Tulin ◽

M. Barbulescu ◽

I. Slavu ◽

V. Braga

Keyword(s):

Sleeve Gastrectomy ◽

Case Report ◽

Laparoscopic Sleeve Gastrectomy ◽

Treatment Of Obesity

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Symptomatic Stenosis after Laparoscopic Sleeve Gastrectomy - Incidence and Management in a High-Volume Bariatric Surgery Center

Chirurgia ◽

10.21614/chirurgia.113.6.826 ◽

2018 ◽

Vol 113 (6) ◽

pp. 826 ◽

Cited By ~ 3

Author(s):

Florin Turcu ◽

Cristian Balahura ◽

Ionut Doras ◽

Alina Constantin ◽

Catalin Copaescu

Keyword(s):

Bariatric Surgery ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

High Volume ◽

Bariatric Surgery Center ◽

Surgery Center ◽

Symptomatic Stenosis

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Medication Use After Laparoscopic Sleeve Gastrectomy: One Year Results From The (Province) Bariatric Surgery Cohort Study

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2013.03.207 ◽

2013 ◽

Vol 37 ◽

pp. S253-S254

Author(s):

Justin Peddle ◽

Kendra Lester ◽

Carla Dillon ◽

Deborah M. Gregory ◽

Lauire Twells

Keyword(s):

Bariatric Surgery ◽

Cohort Study ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Medication Use ◽

One Year

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Association of Bariatric Surgery Using Laparoscopic Banding, Roux-en-Y Gastric Bypass, or Laparoscopic Sleeve Gastrectomy vs Usual Care Obesity Management With All-Cause Mortality

JAMA ◽

10.1001/jama.2017.20513 ◽

2018 ◽

Vol 319 (3) ◽

pp. 279 ◽

Cited By ~ 87

Author(s):

Orna Reges ◽

Philip Greenland ◽

Dror Dicker ◽

Morton Leibowitz ◽

Moshe Hoshen ◽

...

Keyword(s):

Bariatric Surgery ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Usual Care ◽

Laparoscopic Sleeve Gastrectomy ◽

Obesity Management ◽

All Cause Mortality ◽

Laparoscopic Banding

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Lithium toxicity following bariatric surgery

SAGE Open Medical Case Reports ◽

10.1177/2050313x20953000 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2095300 ◽

Cited By ~ 1

Author(s):

Suzanna Connick Jamison ◽

Kelley Aheron

Keyword(s):

Bariatric Surgery ◽

Morbid Obesity ◽

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Therapeutic Range ◽

Lithium Therapy ◽

Lithium Toxicity ◽

Psychiatric Comorbidities ◽

Monitoring Protocol

A patient with morbid obesity and several psychiatric comorbidities underwent laparoscopic sleeve gastrectomy and experienced success with weight loss. However, she experienced lightheadedness, nausea, and a fall and was admitted to the hospital for encephalopathy due to lithium toxicity. The pharmacokinetics of lithium is altered following bariatric surgery. Due to these factors, adjustments were made to the patient’s lithium therapy, her levels were subsequently reduced into the therapeutic range, and she continued with no further issues. Mechanisms of lithium toxicity following bariatric surgery and a monitoring protocol to prevent toxicity are discussed.

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