Laparoscopic Sleeve Gastrectomy for Morbid Obesity: UAE Tertiary Care Hospital Initial Experience

Abstract

Aim: To study efficacy of Laparoscopic Sleeve Gastrectomy (LSG) for morbid obesity as a measure of weight reduction over a period of one year from May 2011 – 2012. Materials and Methods: Morbidly obese patients (n=109) referred from clinics with primary problem of obesity and consequent co-morbidities underwent the procedure LSG during a period of one year. The data included; demographics, weight of patients/BMI, Comorbid conditions, preoperative work up, indications for surgery, length of hospital stay, duration of surgery, postoperative complication and reduction of weight at 3 weeks, 3, 6 and 12 months. Results: Out of 109 patients, 94 (86%) are below 40 years of age, reflecting high prevalence of obesity in the younger population in UAE. As per gender, 67 (61.5%) are female and 42 (38.5%) male. Preoperatively, mean weight is 121±16 kg; 68 (62.4%) patients have BMI 40-50 kg/m2 and 41 (37.6%) of 35-40 kg/m2, 12 (11%) patients are diabetics (DM), 9 (8.3%) hypertensive (HTN), 12 (11%) have symptoms of Gastritis, 3 (2.8%) have shown Clo test +ve.,  7 (6.4%) complaining Knee Joint pain, 3 (2.8%) with Backache, 2 (1.8%) patients are diagnosed cases of gastroesophageal reflux disease (GERD), though  58 (53.2%)  have  no comorbidities. Among those 107 (98.2%) patients are referred to dietitian. All patients underwent laparoscopic sleeve gastrectomy (LSG). Postoperatively, 104 (95.4%) patients were without any complication. 1 (0.9%) patient has bleeding while 4 (3.7%) has minor issues (nausea, vomiting) and there was no leak in this group of patients. On follow up, there was a significant weight loss and improvement of comorbidities: At 3 weeks post op, the mean weight was 113±16 kg, at 3 months 103±13 kg, at 6 months 92±12 kg and at 1 year 82±10 kg. Complete resolution of Diabetes Mellitus (DM) observed in 7 (58.33%) out of 12 patients and improvement in 5 (41.55%). Complete resolution of hypertension (HTN) in 5 (55.55) and improvement in 4 (44.44). Gastritis completely resolved in 10 (83.33) and improved in 2 (16.66). The patients who had knee joint pain and backache, all improved. Conclusion: LSG has clearly proven its efficacy for morbid obesity in term of weight reduction and consequent co-morbidities. It’s gaining popular in community being an acceptable and safe procedure.