LSG: Current Controversies

Laparoscopic sleeve gastrectomy (LSG) is still a new procedure with many technical variations. Sleeve volume, bougie size, stapling technique and distance from pylorus may affect medium- and long-term weight loss and metabolic outcomes. Further data and larger series will be needed to draw definitiv...

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Bibliographic Details
Published inObesity, Bariatric and Metabolic Surgery pp. 285 - 295
Main Authors Borg, Cynthia-Michelle, Adamo, Marco
Format Book Chapter
LanguageEnglish
Published Cham Springer International Publishing
Subjects
Banded sleeve gastrectomy
Bougie diameter
Controversies
Hiatus hernia and reflux
Indications
Sleeve gastrectomy
Staple line reinforcement
Stapling distance from GEJ
Stapling distance from pylorus
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Summary:Laparoscopic sleeve gastrectomy (LSG) is still a new procedure with many technical variations. Sleeve volume, bougie size, stapling technique and distance from pylorus may affect medium- and long-term weight loss and metabolic outcomes. Further data and larger series will be needed to draw definitive conclusions. The only technical point beyond controversy and now universally accepted is that an orogastric bougie should always be inserted during stapling. The controversies regarding level of hiatal dissection and staple line reinforcement are more related to perioperative and short term outcomes such as staple line leak rate and postoperative gastroesophageal reflux disease (GERD). Most recent meta-analysis and reviews are in favor of more aggressive hiatal dissection with synchronous hiatal hernia repair and staple line reinforcement; however no consensus has been reached yet.
ISBN:9783319043425
3319043420
DOI:10.1007/978-3-319-04343-2_29