Background

The laparoscopic sleeve gastrectomy (LSG) has become an exceedingly common, reliable bariatric surgery for weight loss and improvement of metabolic comorbidities. The incidence of splenic related complications is low, and as such has not been widely studied. The objective of this case review is to demonstrate a safe and thoughtful approach to LSG after splenic artery embolization (SAE). This case represents a unique circumstance in which the vascular supply to the spleen had been compromised and risk of infarction and further complications created a more complex medical decision making process. In this patient, no adverse outcomes developed, indicating elective sleeve gastrectomy is a safe and feasible procedure after SAE, but the risks should be discussed, imaging reviewed for collateral vessels, pre-operative administration of vaccines imperative, and several key steps taken intra-operatively.