Patients with body mass index (BMI) over 60 kg/m2 are considered super-super obese. This patient group, as well as patients with extreme co-morbidities, creates challenging conditions for bariatric surgery. Each step of laparoscopy, including insufflation, trocar placement, dissection, and performing complex procedures like bypass becomes technically more difficult. Furthermore, there is increased risk of postoperative complications, morbidity, and mortality in these groups. Presently described is adjustable gastric banded sleeve gastrectomy (LabSG) performed in 38-year-old female with BMI of 84.3 kg/m2. Following an uneventful postoperative course, she lost 100 kg in 12-month period and BMI was reduced to 52.7 kg/m2. LabSG seems to be a safe and effective alternative for super-super obese patients at experienced centers.
Keywords: Sleeve gastrectomy, super-super obesity, morbid obesity, adjustable gastric banding, adjustable gastric banded sleeve gastrectomy