Tube Gastrectomy (Sleeve Gastrectomy)

This is a relatively new approach. It is the first component of the duodenal switch operation but is now acknowledged as a stand alone procedure. It involves removing the lateral 3/4 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. But the stomach empties normally.

Although originally intended as a two stage procedure for Patients with super obesity, there is now strong evidence to show that it works just as well as a single stage procedure providing the initial sleeve volume is small enough ( ideally 100-150mls). The sleeve gastrectomy is the only truely "reductive" procedure. It leaves patients with a small but functionally normal stomach which allows a near normal selection of foods in much reduced volume.

An additional effect is that removing 3/4 of the stomach reduces the amount of the hunger hormone Ghrelin that is produced so that for the first 6 months most sleeve patients notice a significant reduction in hunger and appetite.

It is ideal for patients who live or work in remote areas because no post operative adjustments are possible or required.

Unlike the band and gastric bypass there is no outlet restriction so patients can eat just about whatever type of food... just much smaller amount. Typically an entree size portion feels like a banquet. Also unlike the band there is an absolute volume block to liquids, so it is much harder to cheat on high calorie liquids.

The weight loss with the sleeve is more rapid than a Band and approaches that of a bypass, being 65 - 70% by one year and 65% by three years. The sleeve does stretch up a little over time. This is common to all baritaric operations.

If there were to be significant weight regain, the sleeve can be further reduced by resleeving, or a band placed around the sleeve or a bypass created from it.

It might also be a good option if patients have a problem with their lap band requiring revision, have already lost a lot of weight and don't want a full bypass.

Video Presentations

Tube Gastrectomy or Sleeve Gastrectomy- Discussion with Dr. Leon Cohen
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Tube Gastrectomy or Sleeve Gastrectomy in the NEWS
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Tube Gastrectomy or Sleeve Gastrectomy Patient
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