Sleeve gastrectomy
Encyclopedia
Sleeve gastrectomy is a surgical weight-loss
Weight loss
Weight loss, in the context of medicine, health or physical fitness, is a reduction of the total body mass, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue...

 procedure in which the stomach
Stomach
The stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...

 is reduced to about 25% of its original size, by surgical removal of a large portion of the stomach, following the major curve
Greater curvature of the stomach
The greater curvature of the stomach is directed mainly forward, and is four or five times as long as the lesser curvature.-Surface:Starting from the cardiac orifice at the incisura cardiaca, it forms an arch backward, upward, and to the left; the highest point of the convexity is on a level with...

. The open edges are then attached together (often with surgical staple
Surgical staple
Surgical staples are specialized staples used in surgery in place of sutures to close skin wounds, connect or remove parts of the bowels or lungs. A more recent development, from the 1990s, uses clips instead of staples for some applications; this does not require the staple to penetrate.Stapling...

s) to form a sleeve or tube with a banana shape. The procedure permanently reduces the size of the stomach. The procedure is performed laparoscopically and is not reversible.

Procedure

Sleeve gastrectomy (also called gastric sleeve) is usually performed on extremely obese patients, with a body mass index
Body mass index
The body mass index , or Quetelet index, is a heuristic proxy for human body fat based on an individual's weight and height. BMI does not actually measure the percentage of body fat. It was invented between 1830 and 1850 by the Belgian polymath Adolphe Quetelet during the course of developing...

 of 40 or more, where the risk of performing a gastric bypass or duodenal switch
Duodenal switch
The duodenal switch procedure, also known as biliopancreatic diversion with duodenal switch or gastric reduction duodenal switch , is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect....

 procedure may be too large. A two-stage procedure is performed: the first is a sleeve gastrectomy, and the second is a conversion into a gastric bypass or duodenal switch. Patients usually lose a large quantity of their excess weight after the first sleeve gastrectomy procedure alone, but if weight loss ceases the second step is performed.

For patients that are obese but not extremely obese, sleeve gastrectomy alone is a suitable operation with minimum risks. The sleeve gastrectomy currently is acceptable weight loss surgery option for obese patients as a single procedure. Most surgeons prefer to use a bougie between 32 - 60 Fr with the procedure and the ideal approximate remaining size of the stomach after the procedure is about 15 mL.
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