Dr. Mahesh Channappa Podcast

This case highlights a technically difficult laparoscopic sleeve gastrectomy performed in a patient with macronodular cirrhosis of the liver. The enlarged, nodular liver significantly obstructed the surgical field, limiting visibility and access to the stomach.

Careful liver retraction, meticulous dissection, and modified port positioning were required to safely expose the stomach and proceed with the sleeve gastrectomy. Special attention was given to hemostasis due to the increased risk of bleeding associated with cirrhosis.

Despite the anatomical and surgical challenges, the procedure was completed successfully with preservation of surrounding structures. This case demonstrates that with proper expertise, patient selection, and intraoperative strategy, bariatric surgery can be safely performed even in the presence of chronic liver disease.