Greater curvature as a gastric pouch for sleeve gastrectomy: a novel bariatric procedure. Feasibility study in a canine model.

ABSTRACT

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has serious complications, such as leaks, reflux, stenosis, and kinks, which are also consequences of shortcomings in the LSG technique. OBJECTIVES: We evaluated the feasibility and weight loss of a novel bariatric procedure, using the greater curvature as the gastric pouch for sleeve gastrectomy (SG) in dogs. SETTING: Animal house in Faculty of Medicine, Cairo University. METHODS: Five 20- to 25-kg stray mongrel male dogs were subjected to open SG using the greater curve as the gastric pouch (GCSG group). The weight was monitored at day of surgery and at postoperative weeks 2, 4, 6, and 8; weight progression was compared with a sham and a standard SG group. By the end of the follow-up period autopsy was done. RESULTS: The mean operative time in GCSG group was 39.6 ± 3.97 minutes. At the end of the study, dogs in the sham group had gained 8% of their preoperative weight, while the GCSG and standard SG groups lost 24.7% and 25% of their preoperative weight, respectively. At autopsy, the gastric sleeve in the GCSG group showed excellent healing with no stenotic areas, kinks, or mucosal ulcerations. CONCLUSION: Greater curvature SG is technically feasible in a canine model. Larger studies with longer follow-up period will be needed to assess weight progression and resolution of the metabolic co-morbidities.