Publication:
Surgical Technology International XX - Bariatric Surgery
Article title:
Preoperative Prediction of Stomach Weight to Be Removed in Laparoscopic Sleeve Gastrectomy Procedure
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Author(s)
Yaqub M. Baraki, MD
Fellow, Minimally Invasive and Bariatric Surgery
Purnel Traverso, MD
General Surgery Resident PGYII
Hazem A. Elariny, MD, PhD, FACS
Director, Minimally Invasive and Bariatric Surgery
Yun Fang
Statitician
Inova Fairfax Hospital
Falls Church, VA
Abstract
Sleeve gastrectomy (SG) is a surgical procedure that includes a longitudinal lateral gastrectomy to reduce food intake by reducing the capacity of the stomach. The technique of SG as a primary procedure has evolved since it was first introduced in 2001. Some perform the SG over smaller bougie sizes (30-40 Fr) or an NG tube. Some begin the SG near the pylorus (2cm) while others avoid the antral/pyloric area. Establishing the mass or volume of stomach remaining is subject to limitations associated with the in vivo status. However, quantifying the amount (mass) of stomach removed is definitively an objective measure. The study was conducted to determine the relationship between the amount of stomach excised and the patient's gender and preoperative weight and height. Data was collected prospectively and was compiled in a review of 165 (136 Female and 29 Male) patients who underwent laparoscopic SG from December 7, 2001 to March 18, 2004 by a single surgeon at three institutions using the same technique for performance and measurement. The empty weight and capacity of resected stomach specimens were measured intra-operatively and subsequently correlated with the patient's gender, preoperative weight, and height. The mean height of male patients was 179.7+/-7.1 (CM) and the mean height of female patients was 165.1+/-7.1(CM). The mean weight of stomach tissue removed from male patients was 160.3 +/-29.4 (G) and from female patients was 123.5 +/-40.4 (G). The difference in height and weight between men and women was statistically significant (P-value<0.0001). The empty stomach weight and capacity both are linearly related to each other (R-square=0.9292, P-value<.0001). There is evidence showing the statistically significant correlation among preoperative height, gender, and preoperative weight and amount of stomach removed. For the average height patient, removal of gastric tissue weighing less than 160 grams in males and 120 grams in females may indicate an inadequate resection. This removes a stomach capacity of approximately 1600 cc's and 1200 cc's respectively.
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