Feasibility of Laparoscopic Sleeve Gastrectomy for Patients with Obesity and Disorders of Intellectual Development: a Single Institutional Experience.

ABSTRACT

BACKGROUND: Owing to their difficulty following clinical advice for procedural safety and ideal surgical outcomes, bariatric and metabolic surgery (BMS) for patients with disorders of intellectual development (DID) is concerning. Studies reporting the feasibility of BMS for this population remain scarce. This study aims to clarify the feasibility of laparoscopic sleeve gastrectomy (LSG) for patients with clinically severe obesity and DID. METHODS: A retrospective analysis of a single institutional prospective database collected from 2010 to 2022 was performed. The Wechsler Adult Intelligence Scale (WAIS) was used to measure intellectual ability before LSG. A multidisciplinary team approach was implemented to give special support and care to patients with DID. Patients were categorized into groups according to their WAIS scores. LSG outcomes were statistically compared between the DID and average intellectual ability groups. RESULTS: Using the WAIS to measure intellectual ability among patients who underwent LSG, we identified 14 patients with DID (IQ score < 69, mean IQ 63.4) and 71 with average intellectual ability (IQ score 90-109, mean IQ 98.9). Operative outcomes were comparable between the groups as follows operation time (DID 163 ± 41 min, average intelligence 162 ± 30 min), hospital stay (DID 4 [4-5] days, average intelligence 5 [4-6] days), and total comorbidities (DID 7.1%, average intelligence 8.4%). No reoperations were performed, and no mortalities were observed. CONCLUSIONS: With medical and social support and care, performing LSG on patients with clinically severe obesity and DID is safe, with good short-term results.