Laparoscopic gastroplasty for severe obesity: fifteen-month follow-up in the first 150 patients in a consecutive series of 300

OBJECTIVES: The laparoscopic approach for gastroplasty is gaining widesprea d acceptance for morbid obesity. Less invasive and potentially reversible, this gastroplasty guarantees better quality of life. We thus evaluated peri operative complications in our consecutive series of 300 patients and follo wed the excessive weight loss (EWL) for the first 150. PATIENTS AND METHODS: Between April 1997 and January 2000, 300 patients und erwent laparoscopic gastroplasty for severe obesity according to the NIH cr iteria: 266 women, 34 men, mean age 40.1 years (16-66 years). Mean preopera tive weight was 1 18 kg (85-195 kg) and mean body mass index (BMI) was 43.4 kg/m(2) (31.5-65.8). Two hundred one patients had 1.3 comorbidity due to e xcess weight The first 150 patients were followed 15.5 months (12-31) witho ut any lost to follow-up. Medical, dietary and psychological data were reco rded every 3 months for 18 months. The main evaluation criteria was EWL; ot hers were tolerance and morbidity. RESULTS: There was no death. Mean operative time was 129 minutes (50-380), mean hospital stay was 4.76 days 0-42). There were 11 conversions (3.6%). T here were 29 complications (9.6%): 11 were postoperative (5 underwent an ab dominal operation for 2 perforations, 3 early slippages; and 6 respiratory problems with 2 ARDS) and 18 were late complications (7 late slippages, 2 i ncisional hernias and 9 port problems). Follow-up of the first 150 patients was complete: at one year, BMI fell from 43.6 to 33.8 kg/m(2) and EWL reac hed 50.5% at 18 months. CONCLUSION: Our experience is recent, but in light of the danger of the spo ntaneous course of morbid obesity, the results are encouraging due to the a bsence of mortality and the low rate of complications after the first 50 pr ocedures. Half of the excess weight can be lost in one and a half years. Pa tient comfort remains quite acceptable with the active support of the surge ry and medical teams.