First series of laparoscopic sleeve gastrectomy in Sri Lanka-technical feasibility and outcome in a resource poor setting in asia.

Abstract

INTRODUCTION: Morbid obesity and metabolic syndrome are emerging as a major health issues in developing South Asian countries. Laparoscopic Sleeve Gastrectomy (LSG) has been introduced to this region with excellent out comes in controlling morbid obesity and metabolic syndrome. OBJECTIVE(S): Assess the technical feasibility and outcome of LSG as a surgical procedure in a resource poor country in south Asia where Bariatric surgery is still a novel concept. METHOD(S): Prospective Analytical study of the first 15 patients who underwent LSG in a tertiary care hospital in Sri Lanka over 2 years. All data on pre operative, surgical and post operative follow up were recorded in a pre-designed research Performa and all patients were followed up for a minimum period of 6 months by Surgical and Endocrine team. All Surgeries were performed by the same surgeon and the surgical team using total Laparoscopic technique using a 40 F Gastric bougie to standardize the Sleeved stomach. There were 14 females and one male in the study group. Weight range was from 83 to 167 kg with a mean weight of 106.2 kg. Average BMI 45 kg/m2 Results: There were no major complications. The percentage excess weight loss during first 3 months was 28.8 % and at 6 months 42.3 %. Resolution of comorbidities especially Diabetes and Metabolic Syndrome was excellent and one out of two patients who had surgery for subfertility conceived during study period. CONCLUSION(S): LSG can be performed safely in a resource poor setting in south Asia and is effective as a Bariatric surgical procedure for Sri Lankan population.