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Background: Sleeve gastrectomy is being performed increasingly, mainly due to its low morbidity and mortality, but complications do occur. The aim of this study was to evaluate bleeding and leakage rates of primary and revisional sleeve gastrectomy in a personal series of 664 consecutive patients., Methods: Medical charts of all patients undergoing a primary or revisional sleeve gastrectomy between August 2008 and December 2014 were reviewed retrospectively. Subgroup analysis compared bleeding in patients after reduced port versus multiport technique and primary versus revisional sleeve gastrectomy., Results: A total of 664 sleeve gastrectomies (489 women and 175 men) were performed. Mean age and body mass index were 36.03 ± 11.4 years and 42.9 ± 8.3 kg/m 2 , respectively. Mean operative time was 58.5 ± 20.0 min, with a 0.15 % conversion rate. Mean hospital stay was 2.1 ± 0.3 days. The overall 30-day complication rate was 7.5 %. Thirteen patients sustained postoperative bleeding (2 %), three of whom required reoperation (0.5 %). Staple line leakage and mortality were both nil in this series. No difference in postoperative complications was found between the subgroups., Conclusions: In this single-surgeon, single-center experience, sleeve gastrectomy was a safe and effective bariatric procedure with a low complication rate. Staple line reinforcement by oversewing was associated with low bleeding complications and no leakage. The majority of patients with postoperative bleeding could be managed conservatively. In our experience, reduced port technique and revisional sleeve gastrectomy had similar complication rates compared to multiport and primary sleeve gastrectomy.

Background: Weight regain due to gastric pouch dilatation after Roux-en-Y gastric bypass (RYGB) is seen more frequently after long-term follow-up. We studied the feasibility and safety of laparoscopic pouch resizing (LPR) for dilated gastric pouch after RYGB associated with inadequate weight loss., Methods: From 1st June 2011 to 1st September 2013, patients who underwent LPR after failed RYGB were retrospectively compared and analyzed. Data included patient demographics, comorbidity, indication for revision, preoperative weight and BMI, operative time, hospital stay, conversion rate, mean follow-up, body mass index (BMI) loss, percentage excess weight loss (%EWL), reoperation rate, morbidity, and mortality., Results: Out of 170 revisional bariatric procedures, 32 LPR (27/5, F/M) were performed for dilated gastric pouch after RYGB. The mean age, preoperative weight, and BMI were 38.3 ± 9.3 years, 101.7 ± 22.8 kg, 38.8 ± 6.4 kg/m(2), respectively. The median operative time and hospital stay were 100 min and 2 days, respectively. All pouch resizing procedures were carried out laparoscopically, with none requiring conversion to open surgery. The overall complication and reoperation rates were 15.6 and 3.1 %, respectively. There were no deaths. The mean follow-up was 14.1 ± 6.2 months. The mean postoperative BMI was 32.8 ± 7.3 kg/m(2), and the median %EWL was 29.1 %., Conclusions: LPR is safe and can lead to adequate weight loss. However, long-term follow-up is needed to determine the efficiency and durability of this procedure.