Original articleSingle-port sleeve gastrectomy for super-obese patients
Section snippets
Patients and methods
All SOPs (BMI>50 kg/m2) who underwent SPSG in our department from June 2010 to June 2013 were included in our study. The indications for bariatric surgery were in accordance with the French recommendations [16]. All patients underwent meticulous evaluation before surgery by a multidisciplinary team consisting of an endocrinologist, a gastroenterologist, a psychiatrist, a nutritionist, an anesthesiologist, and a surgeon. Appropriate preoperative investigations were performed, as indicated
Results
Sixty-two patients were included in our study (Table 2). Median age was 41 years (range 19–67 years) and 46 patients (74.1%) were women. Median weight was 140 kg (range 121–222 kg), with a median BMI of 52.2 kg/m2 (range 50–87 kg/m2).
Co-morbidities were as follows : T2D in 8 patients (12.9%), hypertension in 30 patients (48.3%), obstructive sleep apnea syndrome in 45 patients (72.5%), hyperlipidemia in 18 patients (29%), degenerative osteoarthritis in 35 patients (56.4%), back pain in 37
Discussion
LSG provides various advantages, such as shorter duration of surgery, absence of gastrointestinal anastomosis and postoperative internal hernias, and lower incidence of vitamin deficiencies or malabsorption [5], [19]. LSG is increasing in popularity, and in the medium-term follow-up, it is an effective weight loss procedure with an acceptable safety profile. LSG using 4 to 7 skin incisions has been proposed as a primary bariatric procedure, even in high-risk patients, such as SOPs. The natural
Conclusion
We have reported the largest series of SPSGs for SOPs in routine practice, showing the feasibility, safety, and efficacy of this technique in this specific population. We should not hesitate to add extra trocars should any technical difficulty arise. SPSG for SOP has to be performed in specialized centers, by bariatric surgeons well-experienced in both conventional laparoscopic surgery and single-incision surgery. Further prospective randomized studies have to performed to recommend SPSG for
Disclosure
The authors have no commercial associations that might be a conflict of interest in relation to this article.
References (28)
- et al.
Long-term remission of type 2 diabetes in morbidly obese patients after sleeve gastrectomy
Surg Obes Relat Dis
(2013) - et al.
Laparoscopic sleeve gastrectomy compared with other bariatric surgical procedures: a systematic review of randomized trials
Surg Obes Relat Dis
(2013) - et al.
Complications after laparoscopic sleeve gastrectomy
Surg Obes Relat Dis
(2008) - et al.
Laparoscopic single-port sleeve gastrectomy for morbid obesity: preliminary series
Surg Obes Relat Dis
(2010) - et al.
Single site laparoscopic sleeve gastrectomy
J Visc Surg
(2012) Comment on: “Laparoscopic sleeve gastrectomy compared to other bariatric surgical procedures: a systematic review of randomized trials.”
Surg Obes Relat Dis
(2013)- et al.
Routine single-port sleeve gastrectomy: a study of 60 consecutive patients
Surg Obes Relat Dis
(2013) - et al.
Five-year results of sleeve gastrectomy
J Visc Surg
(2013) - et al.
Preoperative weight loss in super-obese patients: study of the rate of weight loss and its effects on surgical morbidity
Clinics (Sao Paulo)
(2014) - et al.
Effects of a very low calorie diet in the preoperative stage of bariatric surgery: a randomized trial
Surg Obes Relat Dis
(2015)
Single-incision laparoscopic sleeve gastrectomy for morbid obesity: video technique and review of first 10 patients
Surg Obes Relat Dis
Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications
JAMA
Effects of bariatric surgery on mortality in Swedish obese subjects
N Engl J Med
Bariatric surgery: a systematic review and meta-analysis
JAMA
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