SLEEVE GASTRECTOMY WITH CONCOMITANT ABDOMINOPLASTY: A NOVEL PROCEDURE

Background: Obesity is a major health problem and bariatric surgery has been shown to be the most effective approach in the management of obesity. Abdominoplasty is a common aesthetic procedure for divarication recti with abdominal apron and it has a wide appeal. The aim of this study is to determine the usefulness of laparoscopic sleeve gastrectomy with concomitant abdominoplasty. Subjects/methods: This is a retrospective study over a 7 - year period from 2009 to 2015, conducted on 82 patients who underwent sleeve gastrectomy and simultaneous abdominoplasty at Sunrise Group of Hospitals, Kochi and Dubai. A classical Pfannenstiel incision was made and the skin flap raised, laparoscopic sleeve gastrectomy carried out with the usual port placement directly on the sheath. Ventral hernia (if present) repaired, neoumbilicus created, redundant skin and fat excised and the flap sutured in layers over suction drains. Patients were followed up indefinitely. Results: Eighty two patients underwent combined laparoscopic bariatric surgery and abdominoplasty. Of these, 68 (82.93%) had ventral hernia repair carried out and 14 (17.07%) underwent abdominoplasty alone. The median length of stay was 4 days. 6 patients developed postoperative seroma, and 1 patient had surgical site cellulitis; whereas 3 patients developed surgical site infection. To date, one patient required a revision abdominoplasty. Conclusion: Considering the advantages, comparable hospital stay and the low rate of complications, it would be safe to conclude that LSG with concomitant abdominoplasty is a beneficial procedure in patients of obesity and abdominal apron.