I was reading this in the NUT waiting room, but didn't have time to finish it. Online, all i can find is the summary

http://www.ncbi.nlm....pubmed/20526621

This article was VERY interesting, not the least of which mentioning that leak rates are found to be much higher then the commonly cited 1%.....

Edited to add:

I found the whole text of the article. It was very interesting and I think worthwhile to read

http://www.springerlink.com/content/9751m0k2r0158687/fulltext.pdf

Basically, it looks like rate of leaks and other complications varies alot as the surgically technique has evolved. It is important to know that this data includes some of the earlier surgeries, so maybe that is why the leak rate is higher (around 4%). It does make me wonder though....

This was the gist of it (I copied from the link) but there was more in the printed article.

Impact of surgeon experience and buttress material on postoperative complications

after laparoscopic sleeve gastrectomy.

PG - 88-97

AB - BACKGROUND: Sleeve gastrectomy is gaining popularity whether as a primary, staged

or revisional operation. The aim of this study is to evaluate the perioperative

safety and the learning curve for laparoscopic sleeve gastrectomy (LSG). METHODS:

We performed a retrospective review of the prospectively collected data for all

patients who underwent LSG for the treatment of morbid obesity at our institution

from January 2003 to December 2008. RESULTS: Data from 230 consecutive patients

[male 47%, female 53%; mean age 44.0 +/- 10.0 years, mean preoperative body mass

index (BMI) 56.7 +/- 11.5 kg/m(2)], who were operated upon by three surgeons with

different degrees of bariatric experience, were analyzed. There was no 30-day

mortality, but there were two cases of late mortality (0.87%). Early

complications were noted in 23 cases (10.0%), including 10 cases of leak (4.3%)

and 10 cases of hemorrhage (4.3%). In 17 cases (7.4%) reoperations were

performed. The rates of overall and major complications did not differ among

surgeons or between early and late period of experience for the three surgeons;

this trend held true individually and in subgroups. Overall, over the course of

the learning curve, a significant decrease in operative time was noted. The only

factor that was independently associated with complications was use of buttress

material; the likelihood of complications was found to be 72% lower in patients

in whom buttress material was used. CONCLUSIONS: LSG constitutes a potentially

safe anti-obesity procedure with acceptable morbidity. Experience at the

beginning can be discouraging, even for surgeons with advanced laparoscopic

skills. LSG can be performed safely, with proper mentoring and in appropriate

settings, even by less experienced bariatric surgeons. The use of staple-line

reinforcement was associated with improved perioperative outcomes, and it should

be considered in an attempt to decrease leaks.