An experience of laparoscopic sleeve gastrectomy in obese, morbidly obese, and super morbid obese patients

OBJECTIVE: To report experience with laparoscopic sleeve gastrectomy (LSG) in obese, morbidly obese, and super morbid obese patients, and to evaluate comparative efficacy of LSG among these patient groups.

METHODS: A total of 147 patients underwent LSG between March 2008 and December 2011 at the Department of Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia. Patients were grouped according to the preoperative body mass index (BMI) into obese (35-39.9 kg/m2), morbidly obese (40-49.9 kg/m2), and super morbid obese (>50 kg/m2). Patients who did not have a regular follow-up (n=38) were excluded, and 108 patients were included in this prospective study.

RESULTS: The mean total weight loss (TWL) among the super morbid obese group (41.31 +/- 21.23 kg) was statistically significantly greater compared to the obese group (24.31 +/- 13.00 kg, p=0.009) and morbidly obese group (26.81 +/- 15.56 kg, p=0.001). The mean percentage excess weight loss (EWL) was clinically significant among obese (57.8%), morbidly obese (42.5%), and super morbid obese patients (45.7%), however, it was not statistically significant between the groups (F[2,105]=2.132, p=0.124). There was no mortality; however, 6 major complications occurred including intra-abdominal collection with suspected leak, staple line bleeding, bowel ischemia, and inferior vena cava injury.

CONCLUSION: Laparoscopic sleeve gastrectomy resulted in satisfactory and effective EWL in all 3 groups of obesity patients at 30-months follow-up.