Gastroscopically controlled laparoscopic sleeve gastrectomy.
BACKGROUND
Laparoscopic sleeve gastrectomy is becoming increasingly established as a stand-alone procedure for weight reduction. The restrictive as well as humoral characteristics of this operation assure postoperative weight loss of up to 70-80% after 1 year. Complications also occur with this procedure.


METHODS
The technical details of the sleeve gastrectomy surgical procedure are described, while elaborating on potential complications and on calibration. In our case, we perform gastrectomy under intraoperative gastroscopic control for calibration as well as for suture control as a standard procedure. As a general practice, the staple line is reinforced with the bioabsorbable material Seamguard.


RESULTS
Since June 2006, 38 patients have undergone sleeve gastrectomy.Postsurgical bleeding occurred in 1 case (2.6%) and had to be treated surgically. 1 patient developed cicatricial stenosis and required dilatation (2.6%). After 1 year, 85% of patients had a weight loss of 70-80%.


CONCLUSIONS
Thanks to the standardisation of this procedure using staple line reinforcement and intraoperative gastroscopic control, the complication rate can be reduced and the successful outcome of this stand-alone,weight-reduction operation can be optimised.
Kockerling
Ferdinand
F
Department of Surgery, Centre for Minimally Invasive Surgery, Vivantes Hospital Spandau, Berlin, Germany. ferdinand.koeckerling@vivantes.de
Schug-Pass
Christine
C
D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D005743:Gastrectomy / Q000009:adverse effects / Q000592:standards; D005773:Gastroscopy / Q000009:adverse effects / Q000592:standards; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000592:standards; D009765:Obesity / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D017792:Surgical Stapling; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss