This procedure, also known as tube gastrectomy, is relatively new. It is carried out laparoscopically (keyhole surgery).It involves removing the lateral 2/3 of the stomach (about 70 - 80%) using a stapling device. Most patients stay in hospital 3 – 4 nights.

Sometimes, it can be offered to patients as part of a two stage Gastric Bypass operation, particularly if the patient is super obese (BMI>60), but in recent years it has increasingly been performed as a primary obesity surgical procedure. However, if the weight loss is not satisfactory after 12 months or so, further surgery may need to be considered (ie. further gastrectomy or gastric bypass).

The residual stomach capacity is about 150 - 200 mls (normal stomach is 1,200 -1,500 mls.), so patients feel full after an entrée size meal. A wide variety of food can be eaten and it does not require maintenance, unlike the lapband. It is a “set and forget” type of operation and this makes it particularly attractive for those patients who live in remote areas of Australia ( they do not have to worry re. lapband adjustments). It may also be considered in those cases, who have problems with the lapband, require revision surgery, but do not want a full bypass.

The weight loss achieved with sleeve gastrectomy is as good or better than that achieved with lapband (about 60 – 70% EWL) and it tends to occur more rapidly. However, no long term series (over 5 years) have been reported yet.

Advantages

• Performed laparoscopically and patients usually have a fast recovery with a short hospital stay.
• Effective weight loss averaging 60 – 70% of their excess weight.
• “Set and forget” type of procedure, not requiring adjustments.
• Can eat a wide range of food.
• No malabsorption associated with this operation.
• For well motivated patients, this may be all the operation that is needed.

Disadvantages

• Not reversible.
• Long term outcomes not known.
• Some patients still need a further operation, if weight loss is insufficient.

Risks

• Leakage from the gastrectomy staple line.
• Bleeding