Surgical technique can affect weight loss.

A recent study shows that the way the obesity surgery sleeve gastrectomy is performed can affect the weight loss of patients. Sleeve gastrectomy is a surgical procedure where part of the stomach is removed, resulting in a smaller stomach for the patient.

Approximately half of all obesity surgeries in Norway are sleeve gastrectomies, which amounts to between 800-900 operations per year. However, there is no guarantee that all hospitals perform the operation in the same way. They may use different surgical techniques, which can influence how much weight patients lose after the operation.

Must perform the operation accurately and balanced

The study also shows that the choice of technique is related to gastroesophageal reflux in patients. Gastroesophageal reflux is a condition where stomach acid flows back into the oesophagus, which can lead to symptoms such as heartburn, acid regurgitation, chest pain, and difficulty swallowing.

— On one hand, we see that the smaller the stomach remaining, the greater the weight loss achieved by the patient without an increase in complications. It is natural to believe that a smaller stomach leads to less food intake and thus greater weight loss. On the other hand, we also see that the incidence of gastroesophageal reflux increases the closer to the oesophagus the resection is performed. Therefore, the operation must be carried out in an accurate and balanced manner, being radical with the resection without going too close to the oesophagus.

This is explained by one of the researchers behind the study, Villy Våge. He is a consultant at Haukeland University Hospital and head of the Norwegian Quality Register for Obesity Surgery (SOReg-N).

Register data was crucial for the study

The study is a collaboration between Norway, Sweden, and the Netherlands, and the researchers have used data from the national quality registers in all three countries. Data from the Norwegian Quality Register for Obesity Surgery is included in the study alongside data from the other two quality registers. According to the researchers, register data was crucial for conducting the study and for demonstrating clinical practice at the hospitals in the three countries.

— The study could not have been conducted without register data from the three national registers, says Villy Våge.

— What do you hope this study can contribute to (for both the field and patients)?

— First and foremost, we hope that surgeons become more aware of how important surgical technique is in sleeve gastrectomy so that patients can achieve good weight loss without experiencing more reflux.

Nearly 6000 patients who underwent surgery between 2015–2017 were included in the study.

Here you can read the full study.

Norwegian Quality Register for Obesity Surgery | National Service Environment for Medical Quality Registers