Laparoscopic Gastric Sleeve Resection

The Gastric Sleeve is becoming more popular because of the low risks and great results. Once used as the first Stage of the bypass or biliopancreatic diversion and primarily in the treatment of the super obese (or high risk), the gastric sleeve has found its way into the mainstream of laparoscopic surgery for weight loss. By removing one-third to three-fourths of the stomach, the patient is left with a tube-like effect resembling a sleeve.

The surgery begins with trocars being placed in the abdomen as for the gastric bypass. After devascularization of the greater curvature, dissection begins at the level of the spleen's lower pole. The dissection follows along the path of the lesser curvature and ends when the root of the left pillar of the hiatus is reached. The sleeve or "tube" is being created by using staples and the portion of stomach being stapled out is removed through the trocar hole in the left upper quadrant.

Unlike the Gastric bypass or the Mini-gastric bypass, there is no small bowel intestinal surgery; therefore, all nutrients are absorbed. The complication risks are minimal since the digestive tract stays intact. Typically, appetite is immediately diminished, just like the Lap-Band and older Roux-en-Y gastric bypass, so the patient fills up on small meals. This procedure is usually performed as out-patient with observation as needed. Patients must remain on a liquid diet post operatively for the first few days and then gradually work up to solid foods.

After the initial post operative period, patients must not take aspirin or NSAIDs without protecting the stomach lining. The gastric sleeve makes the stomach more venerable to mucus irritation and swelling, especially with vomiting or anti-inflammatory drug usage.