Bariatric and Metabolic Surgery Unit, Department of Surgery, Ospedale Cardarelli, Naples, ItalyItaly
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Laparoscopic sleeve gastrectomy (LSG) is currently the most performed bariatric procedure in the world. The 4th International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Global registry report (2014-18) estimates 87,015 procedures, equal to 45.9% of all bariatric procedures. Initially performed as the first step of the duodenals witch (biliopancreatic diversion with duodenal switch (BPD-DS)), a very complex malabsorptive procedure invented by a Canadian Surgeon P.
Open Journal Editorial Laparoscopic Sleeve Gastrectomy for the Surgical Treatment of Obesity: Is It an Easy Procedure?
* Emilio Manno, MD* Bariatric and Metabolic Surgery Unit, Department of Surgery, Ospedale Cardarelli, Naples, Italy * *Corresponding author Emilio Manno, MD Head Surgeon, Bariatric and Metabolic Surgery Unit, Department of Surgery, Ospedale Cardarelli, Naples, Italy; E-mail: mannoemilio@gmail.com Article information th th th Received: September 4 , 2020; Accepted: October 9 , 2020; Published: October 13 , 2020 Cite this article Manno E. Laparoscopic sleeve gastrectomy for the surgical treatment of obesity: is it an easy procedure? Surg Res Open J. 2020; 6(1): e1. doi: 10.17140/SROJ-6-e004 aparoscopic sleeve gastrectomy (LSG) is currently the most intervention, but not all obese patients can be treated with this th performed bariatric procedure in the world. The 4th Interna- procedure. For about two years there have been more and more L tional Federation for the Surgery of Obesity and Metabolic Dis- reports of increased incidence of Barrett’s esophagus in operated orders (IFSO) Global registry report (2014-18) estimates 87,015 patients, and of de novo gastroesophageal reflux disease (GERD). procedures, equal to 45.9% of all bariatric procedures. Initially This is probably determined by an inaccurate selection of the pa- performed as the first step of the duodenals witch (biliopancreatic tient: the correlation between syntopathology and gastroscopy diversion with duodenal switch (BPD-DS)), a very complex malab- signs during the pre-operative study and the worsening of symp- sorptive procedure invented by a Canadian Surgeon P. Marceau as toms after surgery is now certain A surgeon must therefore have an evolution of the BPD, invented by N. Scopinaro, an Italian sur- multiple treatment solutions to be able to define himself a bariatric geon, LSG established itself in the early 2000s as a stand alone pro- surgeon cedure, especially following the observations of Michael Gagner, pioneer of bariatric surgery. Over the years LSG has grown rapidly. Adequate Training to Minimizes the Risk of Complications The reasons for this popularity are the relative technical simplici- ty compared to other procedures, efficacy, good quality. For these Leak coming from the “new” stomach is a dramatic event, with a reasons there has been a real explosion of bariatric surgery: many high risk of mortality. It is now well documented that early leaks surgeons, driven by the relative simplicity of the procedure (lon- depend mostly on surgical technique errors.
gitudinal gastrectomy on the guide of a probe), begun to propose this procedure. So is LSG really an effective simple procedure that Starting from this analysis it is essential that anyone who is good for all patients? Absolutely not. Performing a longitudinal wants to perform LSG safely must know what is the correct indi- gastrectomy can be simple; performing a good LSG is not. The ex- cation, how to correctly perform it, how to minimize the risk of ecution of an ideal LSG is essentially determined by three factors: complications.
Adequate Background in Bariatric Surgery In the era of Coronavirus disease 2019 (COVID-19), the use of the webinar is even more a safe and effective means to ex- Laparoscopic sleeve gastrectomy (LSG) is certainly an effective plore topics like the one we talked about.
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