Sleeve gastrectomy

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Sleeve gastrectomy
Gastric sleeve icon.svg
Diagram of a gastric sleeve
ICD-9-CM43.89

Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The result is a sleeve or tube like structure. The procedure permanently reduces the size of the stomach, although there could be some dilatation of the stomach later on in life. The procedure is generally performed laparoscopically and is irreversible.

Procedure[edit]

Sleeve gastrectomy was originally performed as a modification to another bariatric procedure, the duodenal switch, and then later as the first part of a two-stage gastric bypass operation on extremely obese patients for whom the risk of performing gastric bypass surgery was deemed too large. The initial weight loss in these patients was so successful it began to be investigated as a stand-alone procedure.[citation needed]

Sleeve gastrectomy is the most commonly performed bariatric surgery worldwide.[1][2] In many cases, sleeve gastrectomy is as effective as gastric bypass surgery, including improvements in glucose homeostasis before substantial weight loss has occurred. This weight-loss independent benefit is related to the decrease in gastric volume, changes in gut peptides, and expression of genes involved in glucose absorption.[3][4]

Sleeve gastrectomy surgery.

The procedure involves a longitudinal resection of the stomach starting from the antrum at the point 5–6 cm from the pylorus and finishing at the fundus close to the cardia.[5] The remaining gastric sleeve is calibrated with a bougie. Most surgeons prefer to use a bougie between 36-40 Fr with the procedure and the ideal approximate remaining size of the stomach after the procedure is about 150 mL.[6]

Use in children and adolescents[edit]

Endorsed by the International Federation for the Surgery of Obesity and Metabolic Disorders[7] and the American Society for Metabolic and Bariatric Surgery,[8] sleeve gastrectomy is gaining popularity in children and adolescents. Studies by Alqahtani and colleagues have found that sleeve gastrectomy causes large weight loss in children and adolescents aged 5 to 21 years.[9] Moreover, they compared weight loss with adults and found comparable weight loss.[10] Recent reports from the group show that growth progresses unaffected after sleeve gastrectomy in children younger than 14 years of age.[11] Depression following the procedure has been noted in some individuals. Another side effect is insomnia. After this surgery many people can only sleep when they take melatonin or sleeping medications.[12]

Complications[edit]

Sleeve gastrectomy may cause complications; some of them are listed below:[citation needed]

  • Sleeve leaking (occurs 1 in 200 patients)
  • Blood clots (happens 1% of the time)
  • Wound infections (occurs in about 10-15% of post-op patients)
  • Strictures (occurs 3.5% of post-op patients)[13]
  • Aversion to food and nausea[14]
  • Damage to the vagus nerve which will cause constant nausea
  • Gastroparesis, with a delay in moving food from the stomach to the small intestine
  • Vomiting
  • Internal Bleeding
  • Esophageal spasm/pain
  • Gastroesophageal Reflux Disease (GERD)
  • Depression after surgery[15]
  • Hair Loss After Surgery[16]

References[edit]

  1. ^ Chung AY, Thompson R, Overby DW, Duke MC, Farrell TM (August 2018). "Sleeve Gastrectomy: Surgical Tips". Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 28 (8): 930–937. doi:10.1089/lap.2018.0392. PMID 30004814.
  2. ^ Spiegel HU, Skawran S (January 2011). "From longitudinal gastric resection to sleeve gastrectomy--revival of a previously established surgical procedure". Journal of Gastrointestinal Surgery. 15 (1): 219–28. doi:10.1007/s11605-010-1293-9. PMC 3023025. PMID 20725800.
  3. ^ Hutch CR, Sandoval D (December 2017). "The Role of GLP-1 in the Metabolic Success of Bariatric Surgery". Endocrinology. 158 (12): 4139–4151. doi:10.1210/en.2017-00564. PMC 5711387. PMID 29040429.
  4. ^ Cavin JB, Couvelard A, Lebtahi R, Ducroc R, Arapis K, Voitellier E, Cluzeaud F, Gillard L, Hourseau M, Mikail N, Ribeiro-Parenti L, Kapel N, Marmuse JP, Bado A, Le Gall M (February 2016). "Differences in Alimentary Glucose Absorption and Intestinal Disposal of Blood Glucose After Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy". Gastroenterology. 150 (2): 454–64.e9. doi:10.1053/j.gastro.2015.10.009. PMID 26481855.
  5. ^ Paluszkiewicz R, Kalinowski P, Wróblewski T, Bartoszewicz Z, Białobrzeska-Paluszkiewicz J, Ziarkiewicz-Wróblewska B, Remiszewski P, Grodzicki M, Krawczyk M (December 2012). "Prospective randomized clinical trial of laparoscopic sleeve gastrectomy versus open Roux-en-Y gastric bypass for the management of patients with morbid obesity". Wideochirurgia i Inne Techniki Maloinwazyjne = Videosurgery and Other Miniinvasive Techniques. 7 (4): 225–32. doi:10.5114/wiitm.2012.32384. PMC 3557743. PMID 23362420.
  6. ^ Karmali S, Schauer P, Birch D, Sharma AM, Sherman V (April 2010). "Laparoscopic sleeve gastrectomy: an innovative new tool in the battle against the obesity epidemic in Canada". Canadian Journal of Surgery. 53 (2): 126–32. PMC 2845949. PMID 20334745.
  7. ^ "International Federation for the Surgery of Obesity and Metabolic Disorders".
  8. ^ "Bariatric Surgery Procedures". The American Society for Metabolic and Bariatric Surgery (ASMBS).
  9. ^ Alqahtani AR, Antonisamy B, Alamri H, Elahmedi M, Zimmerman VA (August 2012). "Laparoscopic sleeve gastrectomy in 108 obese children and adolescents aged 5 to 21 years". Annals of Surgery. 256 (2): 266–73. doi:10.1097/SLA.0b013e318251e92b. PMID 22504281.
  10. ^ Alqahtani A, Alamri H, Elahmedi M, Mohammed R (November 2012). "Laparoscopic sleeve gastrectomy in adult and pediatric obese patients: a comparative study". Surgical Endoscopy. 26 (11): 3094–100. doi:10.1007/s00464-012-2345-x. PMID 22648112.
  11. ^ Alqahtani A, Elahmedi M, Qahtani AR (February 2016). "Laparoscopic Sleeve Gastrectomy in Children Younger Than 14 Years: Refuting the Concerns". Annals of Surgery. 263 (2): 312–9. doi:10.1097/SLA.0000000000001278. PMID 26496081.
  12. ^ "Depression after Gastric Bypass Surgery". Psychology Today. Retrieved 2019-04-18.
  13. ^ "Gastric Sleeve Surgery: Common Risks and Complications". Gastric Sleeve Diet Guide. 2016-10-11. Retrieved 16 March 2017.
  14. ^ "Gastric Sleeve Complications Post Surgery". BSIG. Retrieved 5 August 2013.
  15. ^ "Depression after Gastric Bypass Surgery". Psychology Today. Retrieved 2019-04-18.
  16. ^ "جراحی لاغری". جراحی لاغری (in Persian). Retrieved 2020-08-14.

Further reading[edit]

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