Sleeve gastrectomy

Sleeve gastrectomy is the latest surgical approach towards the reduction of excess weight. Originally, sleeve gastrectomy was the first step of the very complex biliopancreatic diversion operation, which was in some cases performed as the first step of a two-stage concept. Against this background, sleeve gastrectomy has developed to become a stand-alone procedure. Due to the excellent results achieved, sleeve gastrectomy is performed increasingly frequently worldwide.

Surgical technique

Sleeve gastrectomy is performed by dividing the stomach lengthwise and removing the larger portion. As the name implies, a sleeve-formed stomach rest is retained with a small reservoir at the pylorus. This reservoir has a total filling volume of approx. 80 ml. The operation is performed laparoscopically (5 tiny incisions). This surgical technique does not damage the pylorus and its nerve supply, so that the stomach can release its contents into the duodenum, as usual.

How does the operation work?

The effective principle behind this type of surgery is restriction, which means that the stomach’s filling volume is significantly reduced. Satiety is achieved earlier. Additionally, removal of the upper portion of the stomach (fundus) also removes the site where the appetite-stimulating hormone ghrelin is generated, as a result of which patients~ hunger is inhibited. A reduction of approx. 60-70% of the excess weight is to be expected.

In contrast to gastric band surgery, no implant complications occur and, in contrast to gastric bypass surgery, no long-term metabolic complications occur. Permanent supplementation with vitamin B12 may become necessary.

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