WOFAPS 2025 8th World Congress of Pediatric Surgery

Esma Sehoviç Keçik, Hakan Seyit, Mirhan Tosun

Istınye University, Medical Park Gaziosmanpasa Hospital

Aim:
Pediatric obesity is a silent epidemic — rapidly increasing, underestimated, and inadequately addressed. As severe obesity and metabolic comorbidities rise in adolescents, the limitations of lifestyle-based interventions have become evident. In line with ESPGHAN (European Society for Paediatric Gastroenterology, Hepatology and Nutrition) and ASMBS (American Society for Metabolic and Bariatric Surgery) guidelines, we aimed to share our experience with laparoscopic sleeve gastrectomy (LSG) in selected pediatric patients.

Methods:
Between 2024 and 2025, 17 adolescents (12–18 years) with BMI ≥35 kg/m² and obesity-related comorbidities underwent LSG. All patients were preoperatively evaluated by a multidisciplinary team including pediatric endocrinology, pediatric psychiatry, nutrition, and surgery. Seven patients were domestic; ten were referred via international health tourism. Preoperative abdominal ultrasound showed ≥ grade 2 hepatic steatosis in 14 patients. The highest BMI was 64.3. All procedures included intraoperative methylene blue leak tests (no leaks observed). Mean operative time was 55 minutes. Oral intake began on postoperative day 1; drains were removed on day 3 prior to discharge.

Results:
No leaks, bleeding, or early complications were recorded. All patients had uneventful recoveries. First-month weight loss ranged from 10–14%. Depending on surgery date, total weight loss reached 20–42%, with no observed weight regain. Clinical improvement was noted in all patients with hypertension or type 2 diabetes. Domestic patients were followed up regularly; long-term follow-up for international patients was limited.

Conclusion:
Laparoscopic sleeve gastrectomy is a safe and effective option in well-selected adolescent patients, with promising early outcomes and no major complications.