Laparoscopic Sleeve/ Tube 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
1. Stomach tube may stretch up over time leading to late weight
regain. The extent of this is currently unknown
2. The amount of weight reduction is in the region of 40-60% of
excess wt lost over the
first 1-2 years.
3. 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
4. There is no malabsorbtion to nutrients
5. If weight is regained the second stage of the BPD the intestinal
bypass can be added...