Gastric Sleeve Gastrectomy

What is a "Sleeve Gastrectomy"?

Wikipedia -

Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 25% of its original size, by surgical removal of a large portion of the stomach, following the major curve. The open edges are then attached together (often with surgical staples) to form a sleeve or tube with a banana shape. The procedure permanently reduces the size of the stomach. The procedure is performed laparoscopically and is not reversible.

The following is from - Endobariatric.com - Dr. Alvarez

The sleeve gastrectomy is an operation in which the left side of the stomach is surgically removed. This results in a new stomach which is roughly the size and shape of a banana. Since this operation does not involve any "rerouting" or reconnecting the intestines, it is a simpler operation than the gastric bypass or the duodenal switch. Unlike the Lap Band procedure, the sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen. 

Patients who should consider this procedure include:

1. Those who are concerned about the potential long term side effects of an intestinal bypass such as intestinal obstruction, ulcers, anemia, osteoporosis, protein deficiency and vitamin deficiency.
2. Those who are considering a Lap Band but are concerned about a foreign body inside the abdomen.
3. Those who have medical problems that prevent them from having weight loss surgery such as anemia, crohn's disease, extensive prior surgery, and other complex medical conditions.
4. People who need to take anti-inflammatory medications may also want to consider this. Usually, these medications need to be avoided after a gastric bypass because the risk of ulcer is higher.

It might also be a good option if patients have a problem with their lap band requiring revision, have already lost a lot of weight and don't want a full bypass. The weight loss seems to be a little better and more rapid than the lap band (60 - 70% EWL) over two years. There is still no long-term data.

What advantages does it have?

1. It does not require disconnecting or reconnecting the intestines (no dumping syndrome).
2. There is no malabsorption of nutrients therefore avoiding anemia, osteoporosis, protein deficiency and vitamin deficiency.
3. Only surgery that substantially removes the "hunger hormone" Ghrelin.
4. It is a technically a much simpler operation than the gastric bypass or the duodenal switch.
5. There is no foreign body inside of you.
6. It does not need adjustments or fills (adjustable band patients must come back for fills).
7. Preserves the pylorus (most patients should not get dumping syndrome).
8. It may be a safer operations for patients with a body mass index (BMI) more than 60. It may be used as the first stage of a 2-stage operation.