Safety Profile and Metabolic Efficacy of Laparoscopic Sleeve Gastrectomy: A Prospective Cohort Study in Tobruk, Libya

Abstract

 Laparoscopic Sleeve Gastrectomy (LSG) has emerged as the most prevalent bariatric procedure globally. While short-term safety profiles are well-documented, continuous evaluation of outcomes in specific demographic cohorts remains essential to refine surgical standards. To evaluate the early complications, safety profile, and weight loss outcomes of LSG performed at Tobruk Medical Center between 2024 and 2025. This prospective observational study included 50 consecutive patients undergoing LSG at the Department of General Surgery, Tobruk Medical Center, Libya, from January 2024 to December 2025. Inclusion criteria followed current international guidelines: BMI >40 kg/m² without comorbidities or BMI >35 kg/m² with at least one obesity-related comorbidity. All patients underwent comprehensive preoperative evaluation, including psychological assessment and esophagogastroduodenoscopy. Patients were followed up for 12 months postoperatively. The mean age was 54 years, and 70% of participants were female. The mean preoperative BMI was 47.3 kg/m². The mean excess body weight loss (%EWL) was 22.5%, 33.5%, 41.2%, 49.7%, and 61.3% at 1, 3, 6, 9, and 12 months, respectively. There were no mortalities. The conversion rate to open surgery was 2% (n=1). Two patients (4%) required return to the operating room; one for port-site bleeding and one for suspected leak, which proved negative upon exploration. No major complications such as confirmed staple line leaks, gastric strictures, or significant hemorrhage occurred. The mean hospital stay was 2.7 days. At 12 months, all diabetic patients showed improved glycemic control, and approximately 50% of patients with hypertension and hyperlipidemia showed significant improvement. LSG demonstrates satisfactory weight loss outcomes and a low complication rate in our cohort. Our experience confirms that LSG is a technically feasible, safe, and effective definitive procedure for morbid obesity in the Libyan population.