Laparoscopic Sleeve Gastrectomy for Morbid Obesity: UAE Tertiary Care Hospital Initial Experience
Zafar Iqbal Gondal *
Department of General and Bariatric Surgery Rashid Hospital, P.O.Box 4545, Dubai, UAE
Ali K. Yammahi
Department of General and Bariatric Surgery Rashid Hospital, P.O.Box 4545, Dubai, UAE
Alya Al Mazrouei
Department of General and Bariatric Surgery Rashid Hospital, P.O.Box 4545, Dubai, UAE
Faisal M. Badri
Department of General and Bariatric Surgery Rashid Hospital, P.O.Box 4545, Dubai, UAE
Juanita Bonilla
Department of General and Bariatric Surgery Rashid Hospital, P.O.Box 4545, Dubai, UAE
Ferial M. Abbas
Department of General and Bariatric Surgery Rashid Hospital, P.O.Box 4545, Dubai, UAE
Ahmad Al Jaziri
Department of General and Bariatric Surgery Rashid Hospital, P.O.Box 4545, Dubai, UAE
*Author to whom correspondence should be addressed.
Abstract
Aim: To study efficacy of Laparoscopic Sleeve Gastrectomy (LSG) for morbid obesity as a measure of weight reduction over a period of one year from May 2011 – 2012.
Materials and Methods: Morbidly obese patients (n=109) referred from clinics with primary problem of obesity and consequent co-morbidities underwent the procedure LSG during a period of one year. The data included; demographics, weight of patients/BMI, Comorbid conditions, preoperative work up, indications for surgery, length of hospital stay, duration of surgery, postoperative complication and reduction of weight at 3 weeks, 3, 6 and 12 months.
Results: Out of 109 patients, 94 (86%) are below 40 years of age, reflecting high prevalence of obesity in the younger population in UAE. As per gender, 67 (61.5%) are female and 42 (38.5%) male. Preoperatively, mean weight is 121±16 kg; 68 (62.4%) patients have BMI 40-50 kg/m2 and 41 (37.6%) of 35-40 kg/m2, 12 (11%) patients are diabetics (DM), 9 (8.3%) hypertensive (HTN), 12 (11%) have symptoms of Gastritis, 3 (2.8%) have shown Clo test +ve., 7 (6.4%) complaining Knee Joint pain, 3 (2.8%) with Backache, 2 (1.8%) patients are diagnosed cases of gastroesophageal reflux disease (GERD), though 58 (53.2%) have no comorbidities. Among those 107 (98.2%) patients are referred to dietitian. All patients underwent laparoscopic sleeve gastrectomy (LSG). Postoperatively, 104 (95.4%) patients were without any complication. 1 (0.9%) patient has bleeding while 4 (3.7%) has minor issues (nausea, vomiting) and there was no leak in this group of patients. On follow up, there was a significant weight loss and improvement of comorbidities: At 3 weeks post op, the mean weight was 113±16 kg, at 3 months 103±13 kg, at 6 months 92±12 kg and at 1 year 82±10 kg. Complete resolution of Diabetes Mellitus (DM) observed in 7 (58.33%) out of 12 patients and improvement in 5 (41.55%). Complete resolution of hypertension (HTN) in 5 (55.55) and improvement in 4 (44.44). Gastritis completely resolved in 10 (83.33) and improved in 2 (16.66). The patients who had knee joint pain and backache, all improved.
Conclusion: LSG has clearly proven its efficacy for morbid obesity in term of weight reduction and consequent co-morbidities. It’s gaining popular in community being an acceptable and safe procedure.
Keywords: Laparoscopic Sleeve Gastrectomy (LSG), morbid obesity, bariatric surgery