Robotic Sleeve Gastrectomy After Liver Transplantation

Background: Obesity following liver transplantation is a common medical problem that increases the morbidity and mortality of patients. Still, no standard of treatment for this type of obesity has been identified. While bariatric surgery has been reported as an option, no specific procedure has been defined. Objective: The authors present a robotic sleeve gastrectomy as a suggested treatment option for a patient with increased BMI following a liver transplant. Setting: The University of Illinois at Chicago. Methods: A 62-year-old woman with a history of liver transplantation followed by obesity, with a BMI of 53 kg/m², underwent a robotic sleeve gastrectomy after being enrolled in the bariatric surgery program. Results: The procedure was successfully completed robotically. The operation lasted 158 minutes with minimal blood loss. There were no complications. At 3 months follow up, the patient’s BMI had decreased to 48 kg/m². Immunosuppressive drugs serum levels were unchanged following surgery and she remained at the same immunosuppressive therapy. Conclusion: Robotic sleeve gastrectomy represents a safe alternative for the treatment of obesity in a transplanted patient. The procedure provides good results with no alterations in the immunosuppressive therapy. Longer follow-up and additional data gained from a larger series is needed in order to make more definitive conclusions.