Gastric Sleeve Georgia
Gastric Sleeve Resection
The Gastric Sleeve Resection is a relatively new procedure that I am offering to selected patients for weight loss. It involves removal of a substantial portion of the stomach leaving a narrow tube along the lesser curve of the stomach. It works well for most patients, and the risks of major complications are only half those of the Roux-Y Gastric Bypass, which as we know is a safe and effective operation. The operation is done laparoscopically, even in massively obese patients.
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The Gastric Sleeve procedure is a purely restrictive operation, so that there are not as many concerns about long term nutritional disorders although we will continue to recommend that patients take a multivitamin and calcium supplement as well as some extra vitamin B-12. Since the intestine is not divided and there are no reconnections, the chances of a leak occurring are much lower. In fact the whole thing started when Dr. Gagne, among others who believe that the duodenal switch procedure is the best operation for massively obese patients (those with a BMI of 60 or more), decided to do the duodenal switch operation in two stages. They did the gastrectomy part first with the idea of coming back at a later date to do the intestinal bypass. They found that most of the patients lost so much weight after the Gastric Sleeve Resection that they did not want or need to go back for the second stage.
At this point, I am offering the Gastric Sleeve Resection to patients in the following categories:
1) Patients with a BMI of 60 or more.
2) Patients who want a procedure that is less risky than a Roux-Y Gastric Bypass, but have concerns about having an implanted medical device or who do not feel that they will be able to make frequent follow-up visits as required for success with Adjustable Gastric Band.
3) As a revision procedure for Band patients or Vertical Banded Gastroplasty patients who fail to lose, or regain weight.
The only downside I see to the procedure at the present time is that there is no really long term follow-up and it is possible that the tube will stretch over time. If that were to happen, I think that going back to convert to a Gastric Bypass is an option, and it would be considerably safer after the patient has lost a good bit of weight.
Peter L. Henderson MD