Sleeve Gastrectomy
Sleeve
Gastrectomy, as a ‘stand-alone’ operation for obesity was initially
developed in the UK, and now makes up about 2% of obesity operations in
the United States of America. The operation was originally performed in
the US as the first stage of a two stage operation (duodenal switch) in
high risk patients. In the last few years it’s acceptance as an
alternative surgical treatment for obesity has grown dramatically.
Sleeve Gastrectomy as a stand alone procedure is a somewhat simpler
procedure than gastric bypass. Weight loss resolutions of comorbity are
good and only a minority of patients need to progress to a bypass or
switch. Like gastric bypass, it lends to reduction in the sensation of
hunger as well as being a relative procedure.
Standard Indications for Sleeve Gastrectomy Surgery
• Body Mass Index (BMI : weight [kg]/height [metres x2]) > 40
• BMI > 35 with co-morbidities
• Medical treatment followed by the patient for one year fails
Advantages
• No digestive anastomosis involved
• No prosthesis is required
• Low risk of peptic ulcer
• Vitamin/mineral absorption influenced only to a minor extent
• Short recovery time
• It is straightforward to connect it to a bypass if weight loss is inadequate
Disadvantages
• Concern about staple-line leakage; the use of staple-line reinforcement (Seamguard, Peristrips, Duet) may lessen this risk
• A small percentage of patients have heartburn after the operation