Aim of study: Laparoscopic sleeve gastrectomy (LSG) is increasingly performed in adolescents but is new technique for paediatric surgeons. We aim to report our evolving technique and it’s safety.
Methods: Records from 2012 – 2017 were retrospectively reviewed. Demographics, body mass index (BMI), pre-op co-morbidities, operative time, length of stay (LOS), additional procedures and perioperative complications were recorded. Data are quoted as median (range).
Results: 22 patients were operated. First 3 underwent Laparoscopic Gastric Band insertion and were excluded from this study.
19 patients underwent Laparoscopic Sleeve Gastrectomy. Age was 17(13-19) years. Pre op BMI was 51.5 (39-65) kg/m2. 18 had OGD and 14 had Tru-Cut Liver Biopsy at the same time. Total operative time was 155 (93-223) minutes. 2 had split leg position while rest were in supine position. 4-port access (n=12) was routinely used. Additional port was used in 7. Drain was not left in last 3 patients. Adult Surgeons assisted electively in 10 cases and as emergency assistance in 3 more cases.
Intra-operative complications of stapling the nasogastric tube (n=1), bleeding from the staple line and liver biopsy site (n=1) were treated successfully. Post-operative nausea, vomiting (n=6) were most common immediate post-operatively. 3 were investigated with contrast swallow (n=2) & CT scan (n=1). Left Lower Lung consolidation/effusion was noted in 1.
LOS was 4(2-8) days. 5 patients required High dependency unit (HDU) stay due to their comorbidities e.g. osteogenesis imperfecta(n=1), obstructive sleep apnoea (n=2), central hypothyroidism (n=1), Asperger syndrome, hypotonia and dyspraxia (n=1).