Rare Complications Following Laparoscopic Sleeve Gastrectomy

Area of Science:

• Surgical Gastroenterology
• Bariatric Surgery Outcomes
• Minimally Invasive Procedures

Background:

• Metabolic and bariatric surgery (MBS) is a leading intervention for obesity management.
• Laparoscopic sleeve gastrectomy (SG) is the most frequent primary MBS procedure due to its feasibility and short-term efficacy.
• While common complications of SG are well-documented, rarer issues remain underrecognized.

Purpose of the Study:

• To review rare (<1% incidence) and underdescribed complications following laparoscopic sleeve gastrectomy.
• To enhance surgeon awareness and provide resources for recognizing and managing these infrequent adverse events.
• To detail the causes, clinical presentation, prevention, and management strategies for these rare SG complications.

Main Methods:

• Literature review focusing on rare complications of laparoscopic sleeve gastrectomy.
• Analysis of reported cases and existing literature on underreported SG complications.
• Synthesis of information on etiology, clinical manifestations, and therapeutic approaches.

Main Results:

• Identified rare complications include splenic injuries, esophageal perforation, staple line malformations, intraluminal device stapling, phytobezoar formation, various fistulas (gastro-colic, gastro-pleural, gastro-bronchial), pancreatic leaks, and portomesenteric venous thrombosis.
• These complications, though infrequent, can lead to significant morbidity if not promptly identified and managed.
• Management strategies vary based on the specific complication and require specialized surgical knowledge.

Conclusions:

• Surgeons must be aware of the spectrum of rare complications associated with laparoscopic sleeve gastrectomy.
• Early recognition and appropriate management are essential to mitigate poor patient outcomes from these underreported issues.
• Further research and education are needed to improve the understanding and handling of infrequent SG complications.