Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The result is a sleeve or tube like structure. The procedure permanently reduces the size of the stomach, although there could be some dilatation of the stomach later on in life. The procedure is generally performed laparoscopically and is irreversible.
The Gastric Sleeve is an ideal choice of procedure for people who want a permanent solution, but
prefer not to have an implanted device, such as a gastric band. This is an exciting weight loss
option that combines many of the advantages of a gastric band with those of a gastric bypass.
Sleeve gastrectomy was originally performed as a modification to another bariatric procedure, the duodenal switch, and then later as the first part of a two-stage gastric bypass operation on extremely obese patients for whom the risk of performing gastric bypass surgery was deemed too large. The initial weight loss in these patients was so successful it began to be investigated as a stand-alone procedure.
Today sleeve gastrectomy is the fastest-growing weight loss surgery option in North America, Europe and Asia. In many cases, but not all, sleeve gastrectomy is as effective as gastric bypass surgery, including weight-independent benefits on glucose homeostasis. The precise mechanism that produces these benefits is not known.
The procedure involves a longitudinal resection of the stomach starting from the antrum at the point 5–6 cm from the pylorus and finishing at the fundus close to the cardia. The remaining gastric sleeve is calibrated with a bougie. Most surgeons prefer to use a bougie between 36-40 Fr with the procedure and the ideal approximate remaining size of the stomach after the procedure is about 150ml.
The Sleeve Gastrectomy aids in weight loss for a number of reasons, including
(1) Similar weight loss to Roux-en-y gastric bypass
(2) Similar reversal of obesity-related health problems, including type 2 diabetes, high blood pressure, fatty liver disease and sleep apnea, as Roux-en-y
(3) Lower complication rates than Roux-en-y
(4) Relatively short hospital stay of approximately one or two days
(5) Lower chance of nutrient deficiency
Sleeve gastrectomy may cause complications; some of them are listed below:
(1) Sleeve leaking
(2) Sleeve bleeding
(3) Blood clots and infections
(4) Aversion to food and nausea
(5) Damage to the vagus nerve which will cause constant nausea
(6) Gastroparesis, with a delay in moving food from the stomach to the small intestine
(8) Oesophageal spasm/pain