Laparoscopic Sleeve Gastrectomy: Comparing Two Techniques

Abstract

Sleeve gastrectomy is the fastest growing bariatric surgery nowadays. This is a prospective randomized study comparing two techniques in performing laparoscopic sleeve gastrectomy. Methods: This is a prospective randomized study of 50 patients divided into 2 groups each of 25 , for whom laparoscopic sleeve gastrectomy was done between July 2016 and December 2016, with a follow-up period of 1 year. Regarding the surgical technique in group (A) dissection of the greater omentum was done till reaching the left crus of the diaphragm then stapling was done after. While in group (B) stapling was done after a small opening was made in the greater omentum then dissection of the greater omentum from the stomach was done. Results: The mean operative time was 63 (±16min) for group A and 55 (±18 min) for group (B). Regarding major perioperative complications there was a case of significant intraoperative bleeding and a case of portal vein thrombosis in group (A) , also there was a case of stricture near the incisura in group (B).There was no mortalities in this study. Mean total blood loss was 70+/-11 mL (group A) and 51+/- 9 mL (group B). Preoperative BMI was 45± 7 in group (A) which decreased to 30± 6 after 12 months, while in group(B), preoperative BMI was 46±5 decreased to 32±1, after 12 months. Conclusion: In this study we compared results of LSG done by two different techniques either to start by stomach full mobilisation then stapling (A) or stapling then mobilisation of the stomach (B). No major differences were observed between the 2 techniques, however patients in group (B) had a shorter operative time and less blood loss.