Sleeve gastrectomy, also called Gastric Sleeve or Vertical Gastric Sleeve (VGS) is a restrictive bariatric surgery. It generates weight loss by restricting the amount of food (and therefore calories) that can be eaten by removing 80 to 90% of the stomach without bypassing the small intestines. During this procedure the surgeon, rather than creating a pouch with silicone rings or polypropylene mesh, creates a small sleeve-shaped stomach by resecting and removing the majority of the stomach. What is left is larger than the stomach pouch created during a Roux-en-Y bypass—and is about the size of a banana.
The removed section of the stomach is actually the portion that “stretches” the most in other bariatric procedures. The long sleeve shaped stomach that remains is the portion least likely to expand over time and it creates significant resistance to volumes of food. In addition, the nerves to the stomach and the outlet valve (pylorus) remain intact and therefore preserve the functions of the stomach while drastically reducing the volume. By comparison, in a Roux-en-Y gastric bypass, the stomach is divided, not removed, and the pylorus is excluded. The Roux-en-Y gastric bypass stomach can be reconnected (reversed) if necessary.
While Sleeve gastrectomy is a valid option for all patients considering bariatric procedure, it was typically considered as the first stage in a two-part treatment for patients with a BMI of 60 or higher. The second part of the treatment can be gastric or billio-pancreatic bypass if weight loss is not satisfactory. Several surgeons worldwide have adopted the procedure and have offered it to low BMI and low risk patients as an alternative to laparoscopic banding of the stomach.
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