BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has recently come to be performed as a sole bariatric operation. The postoperative morbidity and mortality are cause for concern, and possibly are related to non-standardized surgical technique. METHODS: The following is the surgical LSG technique used in 25 morbidly obese patients. Five trocars are used. Division of the vascular supply of the greater gastric curvature is begun at 6-7 cm proximal to the pylorus, proceeding to the angle of His. A 50-Fr calibrating bougie is positioned against the lesser curvature. The LSG is created using a linear stapler-cutter device with one 4.1-mm green load for the antrum, followed by five to seven sequential 3.5-mm blue loads for the remaining gastric corpus and fundus. The staple-line is inverted by placing a sero-serosal continuous absorbable suture over the bougie from the angle of His. The resected stomach is removed through the 12-mm trocar, and a Jackson-Pratt drain is left along the suture-line. RESULTS: The mean operative time was 120 minutes, and length of hospital stay was 4 +/- 2 days. There were no conversions to open procedures. There were no postoperative complications (no hemorrhage from the staple-line, no anastomotic leakage, no stricture) and no mortality. In 1 patient, cholecystectomy was also done, and in 4, a gastric band was removed. During a median follow-up of 4 months, BMI decreased from 43 +/- 5 kg/m2 to 34 +/- 6 kg/m2, and the % excess BMI loss was 49 +/- 25%. CONCLUSIONS: The proposed surgical technique appears to be a safe and effective procedure for morbid obesity.
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has recently come to be performed as a sole bariatric operation. The postoperative morbidity and mortality are cause for concern, and possibly are related to non-standardized surgical technique. METHODS: The following is the surgical LSG technique used in 25 morbidly obesepatients. Five trocars are used. Division of the vascular supply of the greater gastric curvature is begun at 6-7 cm proximal to the pylorus, proceeding to the angle of His. A 50-Fr calibrating bougie is positioned against the lesser curvature. The LSG is created using a linear stapler-cutter device with one 4.1-mm green load for the antrum, followed by five to seven sequential 3.5-mm blue loads for the remaining gastric corpus and fundus. The staple-line is inverted by placing a sero-serosal continuous absorbable suture over the bougie from the angle of His. The resected stomach is removed through the 12-mm trocar, and a Jackson-Pratt drain is left along the suture-line. RESULTS: The mean operative time was 120 minutes, and length of hospital stay was 4 +/- 2 days. There were no conversions to open procedures. There were no postoperative complications (no hemorrhage from the staple-line, no anastomotic leakage, no stricture) and no mortality. In 1 patient, cholecystectomy was also done, and in 4, a gastric band was removed. During a median follow-up of 4 months, BMI decreased from 43 +/- 5 kg/m2 to 34 +/- 6 kg/m2, and the % excess BMI loss was 49 +/- 25%. CONCLUSIONS: The proposed surgical technique appears to be a safe and effective procedure for morbid obesity.
Authors: F B Langer; M A Reza Hoda; A Bohdjalian; F X Felberbauer; J Zacherl; E Wenzl; K Schindler; A Luger; B Ludvik; G Prager Journal: Obes Surg Date: 2005-08 Impact factor: 4.129
Authors: Felix B Langer; Arthur Bohdjalian; Franz X Felberbauer; Edith Fleischmann; Mir A Reza Hoda; Bernhard Ludvik; Johannes Zacherl; Raimund Jakesz; Gerhard Prager Journal: Obes Surg Date: 2006-02 Impact factor: 4.129
Authors: Amit Parikh; Joshua B Alley; Richard M Peterson; Michael C Harnisch; Jason M Pfluke; Donovan M Tapper; Stephen J Fenton Journal: Surg Endosc Date: 2011-11-02 Impact factor: 4.584
Authors: George A Giannopoulos; Nikolaos E Tzanakis; George E Rallis; Stamatis P Efstathiou; Christos Tsigris; Nikolaos I Nikiteas Journal: Surg Endosc Date: 2010-04-16 Impact factor: 4.584
Authors: Christine Stroh; D Birk; R Flade-Kuthe; M Frenken; B Herbig; S Höhne; H Köhler; V Lange; K Ludwig; R Matkowitz; G Meyer; P Pick; Th Horbach; S Krause; L Schäfer; M Schlensak; E Shang; T Sonnenberg; M Susewind; H Voigt; R Weiner; S Wolff; A M Wolf; U Schmidt; H Lippert; Th Manger Journal: Obes Surg Date: 2009-01-29 Impact factor: 4.129
Authors: Ronit T Yehoshua; Leonid A Eidelman; Michael Stein; Suzana Fichman; Amir Mazor; Jacopo Chen; Hanna Bernstine; Pierre Singer; Ram Dickman; Nahum Beglaibter; Scott A Shikora; Raul J Rosenthal; Moshe Rubin Journal: Obes Surg Date: 2008-06-06 Impact factor: 4.129