Laparoscopic sleeve gastrectomy: a first step for rapid weight loss in morbidly obese patients requiring a second non-bariatric procedure.
BACKGROUND
Laparoscopic sleeve gastrectomy is a viable option that is becoming common in the management of morbid obesity. The aim of this study was to examine the effectiveness and safety of laparoscopic sleeve gastrectomy as a primary step for rapid weight loss in patients who required a second non-bariatric procedure.


METHODS
After Internal Review Board approval and with adherence to HIPAA guidelines, we conducted a retrospective review of a prospectively collected database of all patients who underwent laparoscopic sleeve gastrectomy as a primary procedure for a second non-bariatric operation from November 2004 to September 2008 at the Bariatric and Metabolic Institute at Cleveland Clinic Florida. The data was reviewed for age, gender, percentage of excess weight loss (%EWL), preoperative and postoperative body mass index (BMI), morbidity, and mortality. Mean follow-up time was 7 months (range, 2 weeks-12 months).


RESULTS
Laparoscopic sleeve gastrectomy was performed in 18 patients who needed a second non-bariatric procedure such as knee replacement surgery, recurrent incisional hernia repair, laminectomy of the lumbar spine, kidney transplant, anterior cervical discectomy, and nephrectomy. Mean preoperative weight and BMI were 124.9 kg (range, 95.5-172.3 kg) and 44.87 kg/m2 (range, 33.36-58.87 kg/m2), respectively. Mean postoperative weight and BMI were 99.2 kg (range, 68.2-132.2 kg) and 35.79 kg/m2 (range, 23.46-48.97 kg/m2), respectively. There were no conversions to an open procedure in this series. There was no morbidity or mortality in this series.


CONCLUSIONS
In this small group, laparoscopic sleeve gastrectomy appears to be an effective and safe first surgical approach for rapid weight loss in high-risk patients that require a second non-bariatric procedure.
Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL 33331, USA.
Jesus E
JE
Hidalgo
Mayank
M
Roy
Alexander
A
Ramirez
Samuel
S
Szomstein
Raul J
RJ
Rosenthal
D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data; D017586:Diskectomy / Q000706:statistics & numerical data; D005260:Female; D005431:Florida / Q000453:epidemiology; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D059685:Herniorrhaphy / Q000706:statistics & numerical data; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D007796:Laminectomy / Q000706:statistics & numerical data; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000706:statistics & numerical data; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D011300:Preoperative Care; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss