Skip to main content

Advertisement

Log in

Deciphering the Sleeve: Technique, Indications, Efficacy, and Safety of Sleeve Gastrectomy

  • Review
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Some institutions perform sleeve gastrectomy (SG) as the initial operation for high-risk, high body mass index patients planning a definitive weight loss operation in 12–18 months. Other institutions consider SG a viable alternative to other bariatric operations. SG is frequently debated among the bariatric surgeons. Many questions remain about the current state of SG. Should it be performed as a definitive weight loss procedure or as a bridge for another bariatric procedure? Is there a specific BMI at which point SG should be encouraged? Is the weight loss comparable to other bariatric procedures? Is there a higher risk of gastric leak? What is the appropriate sleeve size? What are the hormonal benefits? Does SG predispose to gastroesophageal reflux disease? What is the mechanism of weight loss? Are long-term results available? And what are the complications? We conducted an extensive literature review aiming to resolve these commonly asked questions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Gumbs A, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.

    Article  PubMed  Google Scholar 

  2. Deitel M, Crosby R, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18:487–96.

    Article  PubMed  Google Scholar 

  3. Cottam D, Qureshi F, Mattar S, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.

    Article  PubMed  CAS  Google Scholar 

  4. Hamoui N, Anthone G, Kaufman H, et al. Sleeve gastrectomy in the high-risk patient. Obes Surg. 2006;16:1445–9.

    Article  PubMed  Google Scholar 

  5. Moon Han S, Kim W, Oh J. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.

    Article  PubMed  Google Scholar 

  6. Silecchia G, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg. 2006;16:1138–44.

    Article  PubMed  Google Scholar 

  7. Gumbs A, Modlin I, Ballantyne G. Changes in insulin resistance following bariatric surgery: role of caloric restriction and weight loss. Obes Surg. 2005;15:462–73.

    Article  PubMed  Google Scholar 

  8. Mongol P, Chosidow D, Marmuse J. Laparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: initial results in 10 patients. Obes Surg. 2005;15:1030–3.

    Article  Google Scholar 

  9. Catheline J, Cohen R, Khochtali I, et al. Treatment of super super morbid obesity by sleeve gastrectomy. Presse Med. 2006;35:383–7.

    Article  PubMed  Google Scholar 

  10. Langer F, Bohdjalian A, Felberbauer F, et al. Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Obes Surg. 2006;16:166–71.

    Article  PubMed  Google Scholar 

  11. Zhang W, Mason E, Renquist K, et al. Factors influencing survival following surgical treatment of obesity. Obes Surg. 2005;15:43–50.

    Article  PubMed  CAS  Google Scholar 

  12. Clinical Issues Committee of the American Society for Metabolic and Bariatric Surgery. Position statement: sleeve gastrectomy as a bariatric procedure. Surg Obes Rel Dis. 2007;3:573–6.

    Article  Google Scholar 

  13. Lee C, Cirangle P, Jossart G. Vertical gastrectomy for morbid obesity in 216 patients: report of two-year results. Surg Endosc. 2007;21:1810–6.

    Article  PubMed  Google Scholar 

  14. Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy: a restrictive procedure? Obes Surg. 2007;17:57–62.

    Article  PubMed  Google Scholar 

  15. Roa P, Kaidar-Person O, Pinto D, et al. Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obes Surg. 2006;16:1323–6.

    Article  PubMed  Google Scholar 

  16. Himpens J, Dapri G, Cadiere G. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450–6.

    Article  PubMed  Google Scholar 

  17. Milone L, Strong V, Gagner M. Laparoscopic sleeve gastrectomy is superior to endoscopic intragastric balloon as a first stage procedure for super obese patients (BMI > or =50). Obes Surg. 2005;15:612–7.

    Article  PubMed  Google Scholar 

  18. Baltasar A, Serra C, Perez N, et al. Laparoscopic sleeve gastrectomy: a multipurpose bariatric operation. Obes Surg. 2005;15:1124–8.

    Article  PubMed  Google Scholar 

  19. Langer F, Reza Hoda M, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15:1024–9.

    Article  PubMed  CAS  Google Scholar 

  20. Almogy G, Crookes P, Anthone G. Longitudinal gastrectomy as a treatment for the high-risk super-obese patient. Obes Surg. 2004;14(4):492–7.

    Article  PubMed  Google Scholar 

  21. Regan J, Inabnet W, Gagner M, Pomp A. Early experience with two-stage laparoscopic Roux-en Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.

    Article  PubMed  CAS  Google Scholar 

  22. Parikh M, Young L, Strain G, et al. Laparoscopic sleeve gastrectomy: does bougie size affect mean %EWL? Short-term outcomes. Surg Obes Relat Dis. 2007;3:353–7 (abstract).

    Google Scholar 

  23. Lalor PF, Tucker ON, Szomstein S, et al. Complications after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2008;4:33–8.

    Article  PubMed  Google Scholar 

  24. Givon-Madiala O, Spector R, Wasserberg N, et al. Technical aspect of laparoscopic sleeve gastrectomy in 25 morbidly obese patients. Obes Surg. 2007;17(6):722–7.

    Article  Google Scholar 

  25. Sue-Ling D. Surgical management of morbid obesity. 3rd ed. Oxford: Butterworth-Heinemann; 1995.

    Google Scholar 

  26. Johnston D, Dachtler J, Sue-Ling H, et al. The Magenstrasse and Mill operation for morbid obesity. Obes Surg. 2003;13:10–6.

    Article  PubMed  Google Scholar 

  27. Dapri G, Vaz C, Cadiere G, et al. A prospective randomized study comparing two different techniques for laparoscopic sleeve gastrectomy. Obes Surg. 2007;17(11):1435–41

    Article  PubMed  Google Scholar 

  28. Lin E, Gletsu N, Fugate K, et al. The effects of gastric surgery on systemic ghrelin levels in the morbidly obese. Arch Surg. 2004;139:780–4.

    Article  PubMed  Google Scholar 

  29. Kotidis E, Koliakos G, Baltzopoulos V, et al. Serum ghrelin, leptin and adiponectin levels before and after weight loss: comparison of three methods of treatment–a prospective study. Obes Surg. 2006;16(11):1425–32.

    Article  PubMed  Google Scholar 

  30. Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg. 2008;247(3):401–7.

    Article  PubMed  Google Scholar 

  31. Klaus A, Weiss H. Is preoperative manometry in restrictive bariatric procedures necessary? Obes Surg. 2008 Apr 2 (in press).

  32. Braghetto I, Korn O, Valladares H, et al. Laparoscopic sleeve gastrectomy: surgical technique, indications and clinical results. Obes Surg. 2007;17:1442–50, Mar 12.

    Article  PubMed  Google Scholar 

  33. Bergmann JF, Chassany O, Petit A, et al. Correlation between echographic gastric emptying and appetite: influence of psyllium. Gut. 1992;33(8):1042–3.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert Bell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Akkary, E., Duffy, A. & Bell, R. Deciphering the Sleeve: Technique, Indications, Efficacy, and Safety of Sleeve Gastrectomy. OBES SURG 18, 1323–1329 (2008). https://doi.org/10.1007/s11695-008-9551-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-008-9551-6

Keywords

Navigation