Laparoscopic Sleeve Gastrectomy

Laparoscopic Sleeve Gastrectomy

            The sleeve gastrectomy like the gastric band, the vertical banded gastroplasty, and the megenstrasse and mill procedure is a purely restrictive procedure.  The concept was first conceived by Dr. Jamieson from Australia in 1993 and was later modified by Dr. Gagner from New York in 2001 to include a gastrectomy.  The current form of the sleeve gastrectomy requires stapling the stomach vertically, thereby reducing it to 15% of is normal size.  The remaining 85% is removed from the abdomen at the time of surgery.  This procedure is therefore irreversible.  The sleeve gastrectomy was initially offered as an alternative to gastric bypass in patients who were high risk.  Given the success and the low maintenance compared with that of the gastric banding, the procedure is now being offered to patients who are lower risk and having lower body mass indexes. 

            The sleeve gastrectomy produces weight loss by reducing the stomach to a size that is able to accommodate 1-5 ounces of food depending on the performing surgeon.  This decreased food intake causes a drastic decrease in caloric intake, which ultimately causes weight loss.  Unlike the gastric bypass, there is no manipulation of the small intestine anatomy.  The result is a much decreased risk of vitamin, micronutrient, and protein deficiencies.  There is also a significant decrease in the possibility of intestinal obstruction.  The sleeve gastrectomy is a safe and reasonable alternative to the other restrictive bariatric procedures.