Laparoscopic sleeve gastrectomy (LSG) is an accepted technique in bariatric surgery for reducing obesity. Recent reports indicate it to be effective even in children but it has not been tried in very young children. We report here a case of a 2 and half years old child subjected to LSG for his morbid obesity and associated obstructive sleep apnea and bowing of legs. LSG was performed after investigations ruled out hereditary or genetic causes of obesity. The procedure was well tolerated without any complications and 2 months post surgery, the obstructive sleep apnea decreased substantially. The child was followed up for two years. At the last follow up BMI was drastically reduced from a pre surgical value of 41.1–24 kg/m2 at 24 months post surgery. Prior to our report the youngest child to undergo sleeve gastrectomy was 5 years old from Saudi Arabia. We observed LSG to be safe and effective in reducing obesity and related co morbidities in a two and half year's old child. The results suggest that LSG can be a safe and effective alternative for weight control in morbidly obese children even of less than 3 years of age. However more studies and long term follow up is essential for monitoring the growth and development of children subjected to LSG.

Morbidly obese

Sleeve gastrectomy

10.1016/j.ijscr.2013.07.033

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Retroperitoneoscopic Approach to the Adrenal Glands and Retroperitoneal Tumours in Children: Where Do We Stand?

European Journal of Pediatric Surgery (2003)

Henri Steyaert Michel Juricic C. Hendrice Maria Lembo Mohammed Al Mohaidly

Choosing the best way to approach adrenal gland and retroperitoneal tumours is still difficult. We reviewed our first 10 cases operated on by retroperitoneoscopy and compared this approach with other possible ways described in the literature. There were 2 intraoperative complications: 1 opening of the diaphragm and 1 bleeding. Tumour resection was always complete. There was no conversion. There were no postoperative complications. The retroperitoneoscopic approach for adrenalectomy and retroperitoneal tumour resection is increasingly being used. In children, operation is quite fast, without much blood loss and with spectacular postoperative recovery results. Even for the right side we advocate this approach, due to the particular anatomy (small tumour size, less fat, thinner muscle layers) in this age group. Trained surgeons are, of course, mandatory.

Diaphragm (acoustics)

Retroperitoneal space

10.1055/s-2003-39563

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Citations (25)