Initial Experience Performing Laparoscopic Sleeve Gastrectomy in Community Hospital: Outcome of First 250 Cases

Introduction: This study aimed to review the mid-term results of laparoscopic sleeve gastrectomy (LSG) as a single one-stage operation for morbid obesity. Methods: We performed a retrospective analysis of prospectively collected data from November 2008 to August 2013. A total of 267 patients underwent LSG by a single surgeon at a single teaching institution. Data collected and analyzed included patient demographics, operative time, operative technique, length of stay, complications, learning curve, preoperative body mass index (BMI), and weight loss at 6 months, and 1, 2, 3, and 4 years. Results: The mean preoperative BMI was 47.6 kg/m(2) and the mean age was 42.9 years. Mean operative time (100.3 minutes) significantly improved with increased experience. Patients with at least 6 months' follow-up were included to calculate weight loss (mean follow-up rate 46%). The mean BMI decreased to 36.2, 33.3, 33.3, 37.6, and 35.9 kg/m 2 at 6 months, and 1, 2, 3, and 4 years respectively. Mean percentage excess weight loss (%EWL) was 54.3, 67.2, 58, 54.3, and 61 at 6 months, and 1, 2, 3, and 4 years respectively. We had three major complications (1.1%) and four minor complications (1.4%). Conclusion: LSG is a safe and effective procedure for achieving and maintaining acceptable weight loss for up to 4 years.