Complications associated with laparoscopic sleeve gastrectomy for morbid obesity: a surgeon’s guide

Complications associated with laparoscopic sleeve gastrectomy for morbid obesity: a surgeon's guide

Can J Surg 2013;56(5)347-352 | PDF

Kourosh Sarkhosh, MD, MSc* Daniel W. Birch, MD, MSc*† Arya Sharma, MD, PhD, DSc‡ Shahzeer Karmali, BSc, MD*†

From the *Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, and the Departments of †Surgery and ‡Medicine, University of Alberta, Edmonton, Alta.

Abstract

Obesity is a common disease affecting adults and children. The incidence of obesity in Canada is increasing. Laparoscopic sleeve gastrectomy (LSG) is a relatively new and effective procedure for weight loss. Owing to an increase in the number of bariatric surgical procedures, general surgeons should have an understanding of the complications associated with LSG and an approach for dealing with them. Early postoperative complications following LSG that need to be identified urgently include bleeding, staple line leak and development of an abscess. Delayed complications include strictures, nutritional deficiencies and gastresophageal reflux disease. We discuss the principles involved in the management of each complication.

Résumé

L’obésité est une maladie fort répandue, tant chez les adultes que chez les enfants, et son incidence est en hausse au Canada. La gastrectomie longitudinale laparoscopique (GLL) est une intervention relativement nouvelle et efficace pour la perte de poids. Compte tenu de l’augmentation du nombre d’interventions chirurgicales bariatriques, les chirurgiens généralistes doivent se familiariser avec les complications associées à la GLL et avec leur prise en charge. Les complications postopératoires immédiates de la GLL qu’il faut savoir reconnaître sans retard sont l’hémorragie, les fuites le long de la ligne d’agrafes et la formation d’abcès. Parmi les complications plus tardives, mentionnons les sténoses, les carences alimentaires et le reflux gastro-oesophagien. Nous présentons les principes qui sous-tendent la prise en charge de chaque complication.


Accepted for publication Oct. 24, 2012

Competing interests: None declared for K. Sarkhosh and A. Sharma. D.W. Birch declares having received consultant and speaker fees from Johnson & Johnson, Ethicon Endo-Surgery, Covidien, Olympus, Bard and Baxter. S. Karmali declares having received speaker fees from Ethicon and Covidien.

Contributors: All authors designed the study. K. Sarkhosh acquired the data, which K. Sarkhosh and A. Sharma analyzed. K. Sarkhosh and S. Karmali wrote the article, which all authors reviewed and approved for publication.

DOI: 10.1503/cjs.033511

Correspondence to: S. Karmali CAMIS, Royal Alexandra Hospital 10240 Kingsway Edmonton AB T5H 3V9 shahzeer@ualberta.ca