Gastric Sleeve Surgery

What is Gastric Sleeve Surgery?

This procedure involves removing the outer margin of the stomach to restrict food intake, leaving a sleeve of stomach with the pyloris, the muscle that controls emptying of food from the stomach into the intestine. When a sleeve gastrectomy is performed alone, this procedure functions as a purely restrictive procedure. After the sleeve gastrectomy is performed, the duodenum, which is the first portion of the small intestine, is divided so pancreatic and bile drainage is bypassed. The near-end of the "alimentary limb" is then attached to the beginning of the duodenum, just past the pyloris, while the bile and pancreatic juices move through the long "biliopancreatic limb." A "common limb" is created by connecting the alimentary and biliopancreatic limbs a short distance from the end of the small bowel. Food mixes with the digestive juices in this portion of the intestine and is absorbed. The length of the common limb may vary to regulate the absorption of carbohydrates, protein, fat and other nutrients.

Advantages of the Gastric Sleeve Surgery

• Reduced stomach volume increases feeling of fullness
• Does not require disconnecting or reconnecting of the intestines
• Stomach functions normally allowing most foods to be eaten, just in smaller amounts
• Stomach portion that produces hunger stimulating hormone (Gherlin) is removed
• No dumping syndrome; pyloric portion of stomach left intact
• No intestinal bypass and its associated risks
• Simpler procedure than the gastric bypass
• No foreign bodies used as in band surgery

• Permanent/not reversible
• Minor late weight regain possible (10-20% after 2-5 yrs)
• More surgically involved than LAP-BAND®; greater risk