Other Procedures

Sleeve Gastrectomy

Sleeve Gastrectomy removes greater than 90% of the stomach.  It leaves a thin tube of stomach. This results in a physical restriction to eating due to a smaller stomach. Also food spends less time in the stomach and upper small bowel changing the absorption of food. The Sleeve Gastrectomy was initially proposed as an initial weight loss procedure in the super obese prior to subsequent weight loss surgery at a later date. The Sleeve Gastrectomy is now performed in selected patients as a single step procedure. This is a permanent procedure, which cannot be reversed.

Potential advantages of the Sleeve Gastrectomy include

• A simpler follow-up regime negating the need for adjustment and band inflations
• Some improvement in blood sugar control in diabetics due to faster passage of food through the upper small bowel. This is on top of any improved blood sugar control with weight loss.
• A low level of long term complications requiring reoperation.

Concerns about the Sleeve Gastrectomy include

• A lack of evidence demonstrating sustained weight loss beyond 3-5 years with the possibility of needing future additional weight loss surgery

• A long staple line along the stomach with a risk of staple line leaking or staple line bleeding.
• A potential for long term nutritional and trace element deficiencies requiring nutritional supplementation.
• A potential for stretching of the stomach tube with repeated overeating.