title: Laparoscopic sleeve gastrectomy in patients with abdominoplasty: a case-control study.
abstract: BACKGROUND
  Abdominoplasty is increasingly performed after weight loss surgery. However, performing a laparoscopic sleeve gastrectomy (LSG) after abdominoplasty poses technical challenges.
  
  
  OBJECTIVE
  The present study aimed to compare operative events and postoperative outcomes between LSG patients with and without a history of prior abdominoplasty.
  
  
  METHODS
  University hospital, Qatar.
  
  
  METHODS
  A case-control study was conducted on 2 groups of patients with (n = 33) and without (n = 69) prior abdominoplasty who underwent LSG. Patient demographics, baseline characteristics, as well as operative and postoperative events were compared between the 2 groups.
  
  
  RESULTS
  A total of 102 patients with an average age of 39.6±7.7 years and body mass index (BMI) of 42.8±5.9 kg/m2were included. There were no significant differences between the 2 groups in terms of demographic characteristics, preoperative BMI, and co-morbidities. The number of ports required was significantly higher in the LSG patients with a history of prior abdominoplasty than in the nonabdominoplasty patients. The operation time was also significantly longer in the abdominoplasty patients than in the nonabdominoplasty patients (90.3±36.7 minutes versus 57.1±17.7 minutes; P<.0001). However, no significant differences were observed in terms of postoperative complications, length of hospital stay, and weight loss results.
  
  
  CONCLUSIONS
  LSG after abdominoplasty is associated with longer operative times and the need for additional port placement to overcome the decreased working space. However, operative strategies should be considered to overcome the technical challenges during LSG in patients who underwent a prior abdominoplasty.
authors.affiliation: Bariatric and Metabolic Institute, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, New York. Electronic address: saber6231@gmail.com.
authors.forename: Alan A
authors.initials: AA
authors.lastname: Saber
authors.affiliation: Bariatric and Metabolic Institute, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, New York.
authors.forename: Saeed
authors.initials: S
authors.lastname: Shoar
authors.affiliation: Department of Surgery, Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar.
authors.forename: Moamena
authors.initials: M
authors.lastname: El-Matbouly
authors.affiliation: Department of Surgery, Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Karem
authors.affiliation: Department of Surgery, Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar.
authors.forename: Moataz M
authors.initials: MM
authors.lastname: Bashah
authors.affiliation: Department of Surgery, Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Al Najjar
authors.affiliation: Department of Surgery, Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar.
authors.forename: Mohammad J
authors.initials: MJ
authors.lastname: Alkuwari
authors.affiliation: Department of Plastic Surgery, University Hospitals, Case Medical Center, Cleveland, Ohio.
authors.forename: Hooman
authors.initials: H
authors.lastname: Soltanian
mesh_terms: D061645:Abdominoplasty; D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000295:instrumentation / Q000379:methods; D016022:Case-Control Studies; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012189:Retrospective Studies; D024162:Second-Look Surgery; D013525:Surgical Instruments / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult
keywords: Abdominoplasty; Laparoscopy sleeve gastrectomy; Technical considerations; Weight loss