Plehutsa O. Laparoscopic sleeve gastrectomy in the treatment of patients with obesity

In the current work, the indications for laparoscopic and open sleeve gastrectomy performing in patients with obesity have been optimized on the basis of standardization of preoperative preparation of patients as well as tactical and technical actions of the surgical team. The advantages of laparoscopic approach for sleeve gastrectomy were substantiated on the basis of the analysis of the postoperative morbidity rates and the technique efficiency regarding the reduction of excess body weight, concomitant pathology compensation and the improvement of the quality of life of the patients. For the first time, in order to reduce the level of postoperative complications, the improvement of certain technical aspects of the sleeve gastrectomy, namely the use of a gauge illuminated gastric tube, a tangential direction of the gastric intersection stapling line, an intraoperative test on hemostasis and a modified dynamic volumometry of the resected part of the stomach, an optimization of the stapler choice on the basis results of preoperative zonal endosonography of the stomach wall, use of modified peritonization suture have been implemented.