Laparoscopic sleeve gastrectomy with transit loop bi-partition: A novel bariatric procedure

Abstract

IntroductionObesity is a major health problem facing the Kingdom of Bahrain. Surgical interventions have proven to be the most effective modalities for the management of morbid obesity. Sleeve gastrectomy with transit loop bipartition is a novel bariatric procedure proposed to manage this condition. MethodsA retrospective cohort study was conducted amongst the patients who underwent bariatric surgery in our institute. Patients who underwent a laparoscopic sleeve gastrectomy (SG), One Anastomosis Gastric Bypass (OAGB) and Sleeve Gastrectomy with Transit Loop Bipartition (SG + TB) were compared to each other in intervals over a period of 1 year. Results177 patients were included in this study. 104 patients had a SG, 34 patients had SG + TB and 39 patients had OAGB. The SG + TB group showed the largest reduction in average BMI with a drop of 24.5 kg/m2 over a period of a year compared to 18 and 15.4 kg/m2 in the OAGB and SG groups respectively. The OAGB group had the highest rate of resolution of diabetes mellitus (83.3%) and hypertension (81.2%) over a year. The SG + TB group had the highest rate of resolution in dyslipidemia (76.9%) & sleep apnea (96.9%). The highest rate of complications was encountered with the SG + TB group at 26.5% mostly attributed to malnutrition & hypoalbuminema. ConclusionSG + TB are a novel bariatric procedure with good results in achieving weight loss and resolving comorbidities. More studies are required to fine tune the surgical techniques, limb lengths and establish the procedure's safety profile and effectiveness.