Laparoscopic 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.
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
- There is no malabsorbtion to nutrients
- If weight is regained the second stage of the BPD the intestinal
bypass can be added