top of page
Funcionários do Hospital

Sleeve gastrectomy
(Gastric Sleeve)

grafismos.png
rs=w_400,cg_true.webp

Sleeve gastrectomy (or sleeve gastrectomy, or "Gastric Sleeve") was initially described as part of the biliopancreatic bypass operation. The concept of sleeve gastrectomy evolved from vertical band gastroplasty surgeries (Mason's surgery) and the Magenstrasse and Mill operation, which perform partial tunneling of the small gastric curvature in order to restrict the capacity for food intake. More recently, gastrectomy Vertical surgery was indicated as interval surgery of the biliopancreatic diversion in super-obese or high-risk patients. The immediate results observed with this indication led to the proposal of its isolated use for the treatment of obesity as a single restrictive procedure. Thus, there is a sleeve gastrectomy with different indications at this time:

​

 

  • an integral part of the biliopancreatic diversion;

  • interval surgery in super-obese patients (BMI > 50) ;

  • elderly or high-risk, morbidly obese patients;

  • adverse intraoperative conditions: poor exposure, excessive visceral fat, large liver, intense adhesions or clinical instability;

  • revision surgery after adjustable gastric band failure;

  • other indications: patients with inflammatory bowel disease, celiac disease, severe anemia or liver cirrhosis.

 

 

In addition to these indications, sleeve gastrectomy may prove to be a viable alternative as an isolated treatment for morbid obesity. Some recent publications show that this procedure is relatively safe in terms of morbidity and mortality, with adequate reduction in BMI and loss of excess weight, and a positive impact on the resolution of obesity-related comorbidities.

​

​

Benefits

​

 

  • Sleeve gastrectomy, being a restrictive procedure, is not accompanied by significant side effects in terms of nutritional or vitamin deficiencies;

  • Its failure as an isolated procedure allows it to be complemented both for Roux-en-Y jejunal gastroplasty and for bliopancreatic diversion.

 

 

​

Scratchs

​

 

  • Several aspects deserve further discussion for the acceptance of sleeve gastrectomy as a routine procedure in the surgical treatment of obesity;

  • Published studies still refer to short and medium term results;

  • There is a tendency to regain weight in the later follow-up;  

  • There is a worsening in gastroesophageal reflux in patients with hiatal hernia or reflux prior to bariatric surgery;

  • technical aspects related to the distance from the pylorus at which the gastrectomy begins, the need for calibration and its diameter, type of stapler, reinforcement of the suture line, still need further clarification aiming at the safety and result of the procedure. 

bottom of page