Laparoscopic Sleeve Gastrectomy

Laparoscopic Sleeve Gastrectomy
In their article, The Effect of Laparoscopic Sleeve Gastrectomy on Morbid Obesity and Obesity-Related Comorbidities: A Cohort Study, Cetinkunar, Erdem, Aktimur, Aziret, Ozdas, Yurekli, and Yetisir seek to assess how effective their “initial LSG series of 73 patients on excess weight loss (EWL) and resolution of obesity-related comorbidities in short-term follow-up” was. According to the authors, obesity is regarded a truly significant public health concern across the world today. This, as the authors point out, is more so the case that morbid obesity “is a strong risk factor for several diseases [type 2 diabetes mellitus (T2DM), hypertension, steatohepatitis, pulmonary dysfunction, cardiovascular disease, and malignant tumors] and premature death.” In that regard, therefore, the need to rein in this health condition cannot be overstated. As part of my clinical rotation in the Pre-Surgical Testing unit of the hospital, I was responsible for a morbidly obese patient with a BMI of 38.2 who had both diabetes and hypertension – which, as has been pointed out above, are some of the conditions persons who are morbidly obese are likely to grapple with. It is important to note that gastric bypass procedures constitute a significant percentage of bariatric procedures undertaken in the U.S. As a matter of fact, only a small percentage of bariatric procedures performed in the country constitute of restrictive processes. In essence, the laparoscopic sleeve gastrostomy, simply referred to as LSG, is increasingly becoming a favored procedure as far as bariatric surgery is concerned.
As the authors of this particular study point out from the onset, in comparison to non-surgical treatments, the utilization of bariatric surgery has been demonstrated to be a better alternative or approach in the treatment of morbid obesity and other comorbidities related to obesity. This is more so the case when the said approaches are undertaken with multidisciplinary management. The other non-surgical methods that have been applied in the past to treat morbid obesity include, but they are not limited to, medication, exercise, and dieting. It should, however, be noted that one key downside of these non-surgical treatment methods is that although they usually work in the short-term, they may not have a lasting long-term impact on morbidly obese persons. This is a fact supported by the authors’ assertion to the effect that “several conservative methods, including modification of lifestyle and medical treatment, are far from the desirable success in the long-term weight reduction.” Towards this end, the authors suggest what they refer to as “bariatric surgery in multimodal management modalities.” The latter is inclusive of exercises, regulation of diet, and changes in lifestyle. This approach, as the author further points out is recommended for persons with BMI higher than 40 kg/m². However, those with BMI higher than 35 kg/m² but lower than 40 kg/m², but whose BMI has some association with comorbid disease like is the case with the patient I took care of can still be considered for the surgery. My patient had BMI of 38.2 kg/m².
In this particular study, there was a well-defined exclusion criterion with the elimination being on the basis of “active Helicobacter pylori infection, active gastric ulcer, previous gastric resection or fundoplication, alcohol or drug abuse, psychiatric disorders…” etc. Just as was the case in the study, I took the recordings of my patient’s lipid profile, HbA1c, and comorbidities. Further, just as was the case in the study, I gave my patient deep venous thrombosis prophylaxis 12 hours before the procedure was undertaken. The authors of this particular study came to the conclusion that “laparoscopic sleeve gastrectomy can be accepted as a standalone bariatric and metabolic surgery.” In that regard, therefore, following the surgical procedure, the patient I took care of could manage to reign in their weight problem in the long-term, and thus reap the long-term benefits of weight reduction.