Laparoscopic Sleeve Gastrectomy or Vertical Gastrectomy is a new weight loss procedure becoming increasingly popular.
Sleeve resection is resurgence with modification of an old technique called Magenstrasse and Mill procedure. The following is the picture of the older technique.
With the older technique the majority of the stomach is still left inside.
Following is a picture of the Sleeve Gastrectomy, (newer technique)
Procedure: The Sleeve resection originated as stage 1 of the Duodenal Switch procedure in the super morbidly obese. In some high-risk super obese patients Duodenal Switch is proposed in two stages to reduce the overall risk of complications, technical difficulty and improve outcomes. Stage 1 is the sleeve resection. The proposal is that after patients lose a reasonable amount of weight following the sleeve resection several months later to perform the second stage, which is the intestinal bypass component of the Duodenal Switch. However follow-up studies indicated that a significant number of the sleeve resection patients lost enough weight with Stage 1 that they didn’t need the Stage 2. Therefore the current thought that Sleeve Gastrectomy might work well as an isolated weight loss procedure.
Limitations: The main limitation of this procedure is that there are no long-term results confirming weight loss maintenance since it is a newer procedure. Existing data indicates that weight loss with Sleeve resection is slightly better than Lapband and less than Gastric bypass and the Duodenal Switch. However, with the sleeve there is always the option of adding the intestinal bypass component or converting it to a Gastric bypass if weight loss results are not satisfactory. |
