Gastric Sleeve

Gastric Sleeve or Sleeve Gastrectomy

This is a relatively new approach. It is the first component of the duodenal switch operation and involves removing the lateral 2/3rds of the stomach with a stapling device. It can be done laparoscopically (keyhole surgery) but is not reversible. It basically leaves a stomach tube instead of a stomach sack.

stapling

This is the first component of a BPD-DS where the stomach is reduced in size by removing the lateral 2/3rds leaving the stomach in the shape of a tube.

Sometimes it is offered to patients as part of a two stage bypass operation particularly if they are super obese (BMI>60) because it allows good weight loss until the patient gets down to a safe weight and the more radical bypass can then be offered laparoscopically when they are at a safer weight.

The residual stomach capacity is about 200mls so a generous entree should be possible.

Issues with Sleeve Gastrectomy

  • Stomach tube may stretch up over time leading to late weight regain. The extent of this is currently unknown.
  • The amount of weight reduction is in the region of 40-60% of excess wt lost over the first 1-2 years.
  • It is a good option for people living in remote areas because it is a “set and forget” operation which requires little post op follow up or nutritional supplements.
  • There is no malabsorbtion to nutrients.
  • If weight is regained the second stage of the BPD the intestinal bypass can be added… often laparoscopically as well.